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Insurance company to pay Massachusetts $760K for selling illegal products

April 26, 2011 | Healthcare Finance News Staff

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BOSTON – United States Life Insurance, a subsidiary of AIG, has agreed to pay $760,000 in restitution and fines in a settlement with Massachusetts for selling and marketing illegal health insurance products to consumers.

“When Massachusetts consumers buy health insurance, they should be able to feel confident that the coverage complies fully with Massachusetts law,” said the state's attorney general, Martha Coakley. “Our office will continue to monitor the marketing and payment practices of health insurers issuing coverage for Massachusetts residents to make sure that consumers are not misled and are not denied benefits to which they are legally entitled.”

According to the AG's complaint, U.S. Life sold health insurance policies in Massachusetts that were not authorized for sale and did not cover health services required by Massachusetts law. The mandated services at issue included mental health, maternity healthcare, infertility care, pap test screening, mammography and preventive care for children up to age six. Through these actions, U.S. Life violated the state’s Consumer Protection Act.

[See also: Massachusetts AG report criticizes healthcare cost disparities; Massachusetts AG OKs Caritas Christi deal with provisions]

U.S. Life’s parent company, AIG, did not admit to any wrongdoing as a part of the consent judgment issued in Suffolk County Superior Court. “We remain committed to providing leading products and services to our customers and have agreed to remediate the issues raised by the attorney general for affected policyholders,’’ said Mark Herr, AIG's spokesman, in a prepared statement.

Under the terms of the judgment, U.S. Life will set aside $500,000 as a minimum amount for consumer relief to pay Massachusetts residents who were sold the plans. The company will also send letters to consumers entitled to relief and will refund premiums paid by Massachusetts residents who purchased unauthorized health insurance coverage, less any claims paid under it, to pay for mandated services previously denied to those who were covered under certain health insurance policies.

After affected consumers have been compensated, any remaining portion of the $500,000 will be paid to Massachusetts in addition to the $260,000 that U.S Life has agreed to pay separately.

As part of the consent judgment, U.S. Life did not admit any liability and cooperated fully in resolving the issue.

Related Topics:
  • AIG
  • Boston
  • Community Benefit
  • Martha Coakley
  • Massachusetts
  • Policy and Legislation
  • United States

Reader Comments (2)Login to Post a Comment

Jim Craig says: Insurance company to pay Massachusetts $760k for selling illegal
April 26, 2011 | 4:52PM GMT

Its unfortunate for the citizens of MA that they are not able to purchase healthcare insurance policies that carry a lower price because they don't reimburse for services that the purchaser does not wish to insure against. Of course that is MA's prerogative to restrict trade within their State as the representatives of the citizens believe their constituents wish to be governed. I'm just glad that as a FL resident I am not restricted in this way. I mean, thank goodness for our constitutionally guaranteed republican form of government that prohibits the federal government from imposing such restrictions on trade within each State. See, fortunately in this republican form of government, even if my great State of FL were to legislate such a restraint of trade, I could always move to another State that did not impose such restraint......Wait a minute, what the heck are you talking about that I can't escape from government mandated healthcare insurance policy designs? Oh, Obama lied when he said I could keep my insurance if I wanted to? Oh, the vast majority of Americans won't be able to keep their insurance. Huh, that doesn't sound like America at all to me. What the heck happened? Why don't Americans care about liberty anymore? Well, I sure hope we return to American principles pretty soon, because the only way to flee collectivist central government policy currently is to leave America for one of the much more free societies on this planet. I am still hoping to raise my kids in the America I read about in history books. But if it is gone forever I will have to find a place where they can be free.

kmehler says: Re: Insurance company
April 27, 2011 | 9:25AM GMT

It is unfortunate for the state of MA. Although some would like to pretend we have the luxury of moving state to state, the reality is that the federal government has the say in most of our taxed finances. I think though, that many Americans still care about liberty - some just become greedy, or think they can cheat the system and get away with it (hence the basis of this article). For instance, with the Medicare debate going on presently, Leftists are continuously raging at Republicans over their plan to end Medicare and shrink Medicaid. All of this in addition to cutting more taxes for the wealthy. Yes, we can leave our states, you can even leave Florida if you wish, but the middle-class American may not be able to do that because of small pay checks and high taxes. Let's hope the federal gov't soon finds a compromise, where the future of your children's generations will acquire the "American Dream."

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