Jan 9, 2007 12:56 pm US/Central
UnitedHealthCare Accused Of Breaking Insurance Law
Lincoln, Neb. (AP) ―
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UnitedHealthCare is the largest business segment of Minnetonka-based UnitedHealth Group Inc.
AP
UnitedHealthCare Group violated 18 Nebraska insurance laws hundreds of times during a review period, state insurance regulators say.
In a Nebraska Insurance Department petition, the department said UnitedHealthCare had more than 800 violations, mostly for its handling of claims, from July 1, 2003, through June 30, 2004.
UnitedHealthCare is the largest business segment of Minnetonka-based UnitedHealth Group Inc., the nation's second largest health insurer. The subsidary covers about 250,000 Nebraska residents.
State Insurance Commissioner Tim Wagner said complaints against UnitedHealthCare decreased last year. UnitedHealthCare is trying hard to improve and has done so, in part because of the department's attention, Wagner said.
But the improvements do not remove past violations, he said.
UnitedHealthCare spokesman Gary Thompson said the company was taking the complaints seriously and has seen a decline in them.
"We have cooperated fully with regulatory agencies' examinations and reviews and consistently strive for effective solutions to improve service and monitor our own performance," Thompson said.
United has been working with the Nebraska Insurance Department since late 2004, he said, "and we have been pleased to see steady decreases in the volume of complaints throughout all of 2005 and continuing into 2006."
He said the company's service in Nebraska wouldn't be disrupted by the state review.
Insurance Department attorney Ann Frohman said Monday that a surge of complaints prompted a department review starting in March 2003.
State examiners met with UnitedHealthCare officials, who said they would fix the problems, which persisted, the department said.
In 2005, UnitedHealthCare agreed to settle claims complaints by paying fines of $62,500 and $10,000.
Complaints continued last year, the department said, about claims for chiropractic treatments, mental health, newborn baby care, gastric bypasses and other medical procedures.
Among the company's failures, as cited by the department, were decision delays, wrong decisions about coverage and bad information given to consumers.
The department also said UnitedHealthCare didn't turn over accurate or timely information to the state, didn't have an adequate network of emergency services or mental health and substance abuse treatment in rural areas and didn't provide current lists of its care providers.
Frohman said a state hearing about the department petition was scheduled for Feb. 14 but was delayed by legal procedures until June.
(© 2007 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)
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