Oklahoma City Woman Files Suit Against American Fidelity

By Hubert Vigilla

Published on January 11, 2006

Dolores Metzger, the woman filing the lawsuit, believes that American Fidelity underpaid claims associated with her late son Michael. In one instance, Metzger claims American Fidelity paid only three cents for one of her son's cancer treatments.

The case has been moved from Oklahoma County District Court to federal court. Metzger's attorney, Tony Gould, is currently seeking class-action status for the lawsuit.

The suit makes the claim that company directors at American Fidelity altered their practice concerning payment for claims on limited benefit health insurance policies. The lawsuit also claims that prior to this change, American Fidelity paid the amount that the patient was billed. After the supposed change, American Fidelity issued benefits based on discounted amounts provided by health care providers.

In the company's filing, American Fidelity admitted that prior to 1994 it paid certain covered claims without consideration of discounts. American Fidelity also admitted that since 1994 the company has paid actual benefits on cancer policies based on amounts health care providers accept as full payment. American Fidelity denies, however, that the company violated public policy and Oklahoma law or that the company acted in bad faith.

Michael Metzger purchased a cancer benefit policy from American Fidelity in 1992. He was diagnosed with cancer in November 2004 and passed away on January 4, 2005. Dolores Metzger was the cancer policy's beneficiary.

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