Denial or Underpayment of Benefits under Cancer Insurance Policies
Cancer insurance policyholders who have been paid benefits under a supplemental cancer insurance policy may be entitled to additional compensation. We are investigating the possibility that supplemental cancer insurance company policyholders may have only been paid a small portion of the benefits to which they are entitled from supplemental cancer insurance companies under their supplemental cancer insurance policies.
Some supplemental cancer insurance policyholders were guaranteed, under their cancer insurance policies, that they would receive benefits based on the "actual charges" that appeared on their medical bills for their cancer treatment. Despite this guarantee, some supplemental cancer insurance companies changed their adjusting practices without policyholder consent or knowledge and began to pay benefits based on the discounted payments of medical expenses paid by other major medical insurances, including Blue Cross Blue Shield and Medicare.
As an example, pursuant to the previous adjusting practice, if the doctor billed $5,000 for cancer treatment, the cancer insurance companies would pay $5,000 cash to the cancer policyholder, regardless if the doctor accepted less for his services from the cancer policyholder’s other major medical insurance carriers, including Blue Cross and Medicare.
Under the new adjusting practice, if the doctor billed $5,000 for cancer treatment, and later accepted $2,000 as full payment from Blue Cross or Medicare, the supplemental cancer insurance company would only pay $2,000 cash to the cancer policyholder. With this example, you can easily see that the change in adjusting practice greatly benefits the cancer insurance company, and not the cancer policyholder.
Our firm is currently representing individuals that received the lower benefits and have alleged that the supplemental cancer insurance companies have breached their insurance contracts with their cancer insurance policyholders by paying the lower benefits. Some of the companies that may be involved in this practice are Central United Life Insurance Company, American Public Life Insurance Company, Commonwealth National Life Insurance Company, American Fidelity Assurance Company, and Life Investors Insurance Company.
Hopkins & Campbell, LLP law firm has filed a lawsuit in South Carolina Federal Court seeking class action status on behalf of all people who have ever purchased a cancer policy from the Life Investors Insurance Company of America and administered by AEGON USA, INC. through its various wholly owned subsidiaries, including Transamerica Life Insurance Company.
These polices, which have been sold for more than twenty years, were marketed as a type of "supplemental insurance." Purchasers of these policies were told that their normal health insurance (or Medicare and Medicaid) would not reduce the amount paid to the purchaser but rather the money would be paid directly to them. When bills were submitted to Life Investors Insurance Company of America, AEGON USA, INC. and/or Transamerica Life Insurance Company, they would demand to see how much their health insurance paid before paying any amount on the claim. This is not required under the policy and is a violation of the contract.
These purchasers were also told that they would be paid the "actual charge" of the covered charges for their cancer treatment. Pursuant to the policy Life Investors Insurance Company of America, AEGON USA, INC. and/or Transamerica Life Insurance Company would pay the full value of the charges actually shown on the medical bills. However, when bills were submitted to the insurance company, they would only pay a reduced amount. They claimed that the client was not liable to pay the full amount to the healthcare provider and thus would reduce the amount they paid to the purchaser of the cancer policy. This reduction in reimbursement is a clear violation of the plain meaning of the language in the policy.
If you have ever purchased a cancer policy from Life Investors Insurance Company of America, AEGON USA, INC. and/or Transamerica Life Insurance Company at anytime in the past, you may have legal rights resulting from these improper actions. Even if you have never filed a claim for reimbursement of cancer treatment, you may be entitled to compensation for your loss due to the Life Investors Insurance Company of America, AEGON USA, INC. and/or Transamerica Life Insurance Company’s actions.
Contact the law firm of Hopkins & Campbell, LLP for more information. Please ask to speak with Attorney Susan F. Campbell.
Insurance companies are in business to make a profit. Not paying a claim, delaying a claim payment, or offering an inadequate settlement all help to increase their profits at the expense of their policyholders. At Hopkins & Campbell, LLP, we help our clients receive the benefits they need and are entitled to receive under their cancer insurance policies.
We are here to help you.
Call Hopkins & Campbell, LLP at 803-256-6152 or 1-888-941-4843, or for a free case evaluation. Free confidential initial consultation. No fee unless we recover for you.