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Rogue Agents and Policy Switching – The Hidden Dangers for Consumers and Insurance Brokers

April 2, 2024April 1, 2024 Logan B.

Policy Switching Warning - Health Insurance

Unscrupulous Practices Lead to Stolen Policies and Tax Headaches for Many In an alarming trend across several states, consumers covered by Affordable Care Act insurance plans are finding themselves unwitting players in a dangerous game. Without their knowledge or consent, their health insurance policies are being switched, leaving in their wake potential tax complications and vanished coverage. This epidemic of unsanctioned changes, predominantly observed in Florida, Georgia, and Texas, is stirring both consumer and industry unrest. Government and Industry Responses to Unauthorized Policy Switching and Changes Florida and Texas have…

School superintendant charged with health insurance fraud in heartbreaking case

January 28, 2019January 25, 2019 Julie Campbell

The Indiana educator attempted to seek medical treatment for a student by pretending he was her son. An Indiana school superintendant is now facing several health insurance fraud charges. According to police, the Casey Smitherman attempted to use her health plan to pay for a student’s medical treatment by using her son’s name. “My only concern was for this child’s health,” said Smitherman after charges were laid. Smitherman admitted to understanding that she was committing health insurance fraud. “I know this action was wrong,” she said, proceeding to say that…

Allstate Insurance Company to receive over $6 million in case against S. Florida Clinics

March 15, 2016March 13, 2016 Julie Campbell

More than ten years of legal battles has finally led the insurer to receive several judgments in its favor. The Allstate Insurance Company has been battling its way through court cases for more than ten years and has now received several judgments within the 15th Judicial Circuit Court in Palm Beach County, which were against several health care clinics. The Insurance company claimed the clinics had been engaging in unlawful and fraudulent practices. These judgments were made in favor of Allstate Insurance on behalf of the policyholders in litigation that…

Fraud is delivering a blow to health insurance exchanges in the US

November 25, 2015November 24, 2015 Marc

Health insurance exchanges are working to fight fraud Fraud in health insurance exchanges throughout the United States may draw more criticism toward the Affordable Care Act. The federal health care reform law was meant to bring health insurance coverage to millions of people through the establishment of exchange marketplaces. While the law has succeeded in this endeavor, these exchanges are struggling to combat fraud coming from those that want coverage and want to take advantage of the electronic system governing these exchanges. Brokers are using fictitious information to enroll individuals…

Insurance fraud uncovered in Utah substance-abuse clinics

October 28, 2015October 26, 2015 S.Vagus

workers compensation scam insurance fraud

Investigator uncovers troubling insurance fraud problem in the state Insurance fraud has become a major problem in Utah, with substance-abuse treatment centers finding financial success through fraudulent billings. Randy Mauer, an investigator for Cambia Health Solutions, spoke with state lawmakers concerning the issue, suggesting that these treatment clinics are bringing in tens of millions of dollars due to their fraudulent practices. The issue may be quite severe, which could have serious implications for the state’s health insurance market. Fraud seems to be targeting insurers owned by Cambia Health Solutions Investigations…