In the current economic and political environment, many people are left with questions about their health care coverage. When individuals find a plan that meets their needs — both for health coverage and budget purposes — they are usually very happy. Reading the fine print and asking questions is essential to understanding health insurance benefits. A class action lawsuit filed against a California insurance provider claims the insurance company didn't do enough to inform policy-holders about benefits.
The lawsuit was filed against Anthem Blue Cross of California. The suit claims that the insurance company defrauded millions of enrollees because it mislead policy-holders about coverage under plans. Specifically, the suit claims that policy holders were not correctly informed about what hospitals and doctors would be covered under the plans.
According to the suit, the insurance company allegedly didn't let policy-holders know that services performed by providers outside of the plan's network would become the financial responsibility of the insured. Reportedly, some policy-holders are now facing thousands in medical bills they didn't realize they would be responsible for. Other policy-holders have been unable to see their personal physicians, which is something they didn't expect going into the plan, says the suit.
According to an Anthem spokesperson, the insurance company is going to pay medical bills for individuals who saw providers that were incorrectly identified as in network. However, that arrangement will only cover individuals who have bills with dates of service in the first three months of 2014. The suit alleges that there are enrollees who experienced the same problem after those dates.
Individuals can feel like David challenging Goliath when they go up against large corporations. A class action suit is one way consumers can band together for legal battles with entities that usually have more resources than a single individual.
Source: Source: Kaiser Health News, "Lawsuit Accuses Anthem Blue Cross of 'Fraudulent' Enrollment Practices," Julie Appleby, July 9, 2014