3 Possible Ways Your Medical Insurer Could Be Defrauding You

By: Don Saunders

The increasing number of consumers taking up health insurance policies has led to a mushrooming of scam health insurance providers. These health insurance providers often target new retirees and seniors who can’t negotiate better rates with legitimate insurers. Read on to learn about 3 ways in which your health insurer could try to scam you.

1. Not paying claims

Usually fraudulent health insurance agents try to sign up a huge number of people quickly by making them very lucrative offers. These insurance providers themselves pay small premium amounts and settle small medical claims however, if there is a large claim arises or if the regulators catch up with them, these companies will simply vanish as if they never existed.

So, just beware if you you encounter delays in receiving payments or if your service provider is offering lame excuses for their failure to make the payments. If you have one of these illicit plans you could also find that you are liable for the medical bills of your employees as well if you have taken out a plan as a small business employer.

2. Offering health plans that are not licensed

If your insurance company is not licensed by State Insurance Commissioner then you can find yourself in difficulty. In these circumstances your service provider is almost certainly conning you by selling non-licensed health plans.

You also need to know that agents are not allowed to provide ERISA or union plans, both of which are regulated by federal law. If therefore your agent tries to offer you an ERISA or union plan you need to report this to your state insurance department.

3. Unusual coverage being offered at lower rates

If you are offered a high level of coverage irrespective of your health condition and at a lower rate than you would expect from other insurers then this should start the alarm bells ringing. Do not be taken in by a seemingly very attractive offer as you are very likely to find yourself being taken for a ride. The scammers aim to collect very large amounts of money as early as possible and so they attempt to sell as many policies as they can as quickly as they can before they disappear.

Naturally these are just some of the many tricks that the fraudsters use but in most cases the presence of one or more of these ploys ought to cause you to stop and look closely at exactly what you are getting.


About the Author
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