School superintendant charged with health insurance fraud in heartbreaking case

health insurance fraud - hand cuffs

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…

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

Allstate Insurance company news

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…

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

Health insurance fraud and abuse

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…

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Insurance fraud uncovered in Utah substance-abuse clinics

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…

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Insurance fraud is a costly problem

Medical Fraud

Insurance fraud makes coverage a complex matter Insurance can be a very tricky subject to navigate. Every sector of the insurance industry is awash with regulations, standards, and complex business practices that can make understanding coverage a chore at best. The complexities of insurance can cause a great deal of confusion, even among those that should not be confused. In the U.S., state and federal lawmakers often pass legislation in an attempt to mitigate the dangers that exist within the insurance sector. Much of this legislation institutes regulations that govern…

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Health insurance fraud spikes as exchanges go live

Health Insurance rate increases

Health insurance regulators are combating a tide of fraud Health insurance exchanges throughout the U.S. have proven popular with consumers, but many people may be at risk of falling victim to fraud and misleading tactics by those that seek financial gain. The New Hampshire Insurance Department has sent a cease and desist letter to an insurance brokerage based in Arizona this week. The company is being accused of misleading New Hampshire residents into thinking that it represented the state’s health insurance exchange. The company’s website has since been taken down,…

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Health insurance scams may emerge as exchange pick up momentum

Health Insurance Exchange

Consumers warned to be cautious of health insurance scams Health insurance exchanges have officially launched throughout the U.S. as part of the Affordable Care Act. The exchanges are meant to provide people throughout the country with access to affordable health insurance plans. So far, these exchanges have been quite popular, with consumers flocking to the virtual marketplaces to find policies. In New York’s exchange, more than 10 million people attempted to purchase coverage through the state’s exchange on its first day. While these health insurance exchanges seem popular with consumers,…

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