Connecticut Investigates Health Insurance Companies

By Cecilia Green

Published on October 20, 2005

During a lawsuit against Health Net in 2001, the insurance company agreed to pay 98 of its members over $160,000 in a legal settlement. The insurance company had been illegally seeking reimbursement from fully insured plan members who received personal injury awards in court.

Members of fully insured plans that receive court awards typically have the amount paid by their insurance already deducted from the total. Therefore, they should not have to pay the insurance company again.

Although Health Net did not admit any wrongdoing, claiming they had a different interpretation of the law, they agreed to stop this practice, as did all other insurance companies.

However, due to a recent complaint from a woman who claimed Health Net was illegally seeking reimbursement after she received a personal injury award for a car accident, the state of Connecticut intends to investigate all health insurance companies to make sure this practice has stopped.

While it is legal in Connecticut for insurance companies to seek reimbursement from members of self-insured plans, it is illegal to seek reimbursement from plan members who have full insurance coverage, or members of church or government health plans.

Next year, the state legislature hopes to pass a law against health insurance companies collecting reimbursement from self-insured plan members as well.

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