Recently, there has been another settlement in a case against an insurance company in regarding unfair insurance practices. According to news sources, last month the current Los Angeles city attorney, announced a settlement of $6 million from Anthem Blue Cross; although the company still hasn’t admitted any fault in the matter. Before the settlement, the case was in Los Angeles Superior Court as People v. WellPoint, Inc. et al., WellPoint being Anthem’s parent company. The company has about 1.8 million policies in the state. The lawsuit against Anthem was filed in 2008 alleging that the insurance company illegally dropped 6,000 policyholders between 2002 and 2008. The city attorney at the time said that most of those affected were elderly Anthem customers with high medical bills, some higher than $100,000. Mr. Delgadillo alleged that Anthem used internal units to target ill policyholders and that hundreds of thousands of customers bought policies under the company’s false advertising. At the time it was filed, the lawsuit asked for $1 billion in damages. In 2010, former LA city attorney Carmen Trutanich amended the complaint against Anthem and its parent company to allege that the company issued four misleading and false press statements in April and May 2010, which the city attorney alleged were unlawful, unfair, and fraudulent business practices. One such false statement highlighted was a statement that the company would change its practices on cancelling policies by May 2010. It did not do. The city attorney claimed that the insurance policies the company sold to Californians were “largely illusory health care coverage” because of the company’s cancellation policies. At that point, the city was asking for restitution for consumers, civil penalties, and a court order telling WellPoint and Anthem to stop these business practices. Unfortunately, in the settlement agreed upon, none of the money will go to restitution for the policyholders who were affected. Some suffered horribly because of these unfair insurance practices, such as one patient who had a hysterectomy for endometrial cancer but had her coverage cancelled because she didn’t report having breast cancer 11 years prior. The insurance application only asked for the last ten years of medical history and an agent told her she did not have to list her breast cancer. Instead of going to help those individuals harmed by these practices, half of the $6 million settlement will go to the city of Los Angeles and the other half to the county, to be used for consumer enforcement measures. The settlement includes nothing about reinstating unfairly cancelled policies, either. The city of Los Angeles said, however, that the settlement took into account Anthem Blue Cross’s efforts to increase policy safeguards and implement a new independent review process for cancelling policies and allow for revising applications.
The case between LA and Anthem shows how difficult insurance cases are and, when there are so many policyholders affected, how individuals can get lost. If an insurance company is trying to deny you benefits or coverage, contact an experienced insurance lawyer today to talk about your case.