Personal Injury Law

Fortis/Time/Assurant Health Insurance Denials and Rescissions

By Nick DiCello

    Fortis Insurance Company, now known as Time Insurance Company, and which also uses the name Assurant Health, is one of the largest individual health insurance providers in the United States.  Time/Fortis' conduct with respect to accepting applications, underwriting policies, refusing to pay claims, and canceling coverage has come under increasing scrutiny over the past several years.  Several States' Departments of Insurance have investigated the company's policies and procedures by performing Market Conduct Examinations.  Several of these Examinations have concluded that Fortis/Time's practices violate state and federal law and insured's rights.  Fortis has been fined by several different states for their conduct.

    On May 24, 2007, the CBS evening news ran a story on Fortis' practices.  CBS news correspondent, Armen Keteyian, reported the story.  The report detailed Fortis' refusal to cover expensive claims submitted by insureds on the alleged basis of pre-existing conditions.  CBS' investigation revealed "a pattern of questionably denied claims and concealed policies, and what a South Carolina judge called a culture of 'secrecy, concealment and shredded documents.'"  A former Fortis supervisor at a unit in Fortis that serched for reasons not to pay claims told CBS she quit because she believed many of the investigations were unfounded and unjust.

    In the eyes of the law, according to Fortis' own former supervisors, Forts conducts investigations in bad faith.  An insurer cannot consider the economic impact of covering a claim.  Rather, an insurer owes its insured a duty to represent the insured's interests with equal regard as the company's.  Bad faith claims denial and contract rescission is against the law in every state and subjects insurers to punitive damages.  Recently, a jury in South Carolina awarded a former Time insured $15 million when Fortis improperly cancelled his insurance coverage.  The jury imposed $10 million in punitive damages to punish Fortis for its bad faith policies and procedures.

    Fortis' automated claims processing system seeks to weed out expensive and potentially expensive claims for investigation in an effort to avoid payment as a pre-existing condition, or seeks to cancel coverage on the basis that the insured made material misrepresentations on his or her application for insurance coverge.

    If you or someone you know has had claims denied by Fortis or had coverage rescinded/canceld by Fortis, you should contact an attorney to review the circumstances surrounding the cancellation or denial

Full post as published by Cleveland Personal Injury Lawyer on May 17, 2008 (boomark / email).