Are You a Victim of Insurance Fraud?
Los Angeles City Attorney Rocky Delgadillo attempted to continue his attack on unfair and unlawful insurance industry practices today by demanding that the state's top insurance and managed health care officials include him in any discussion about new laws addressing illegal policy cancellations. He's afraid lawmakers are being unduly influenced by insurance industry lobbyists at the expense of consumers.
Delgadillo's letter follows a lawsuit his office filed in February against Health Net, alleging it engaged in a scheme to cancel patients' policies just as they are about to undergo expensive treatments. His office also launched a Web site, www.ProtectingTheInsured.org, several months ago for people and health care professionals to report purported misconduct by health insurers.
The press release follows on the jump.
FOR IMMEDIATE RELEASE
THURSDAY, APRIL 3, 2008
CITY ATTORNEY DELGADILLO CALLS FOR TRULY INDEPENDENT RESCISSION REVIEW
PROCESS, URGES STATE REGULATORS TO GIVE PROSECUTORS ROLE IN CRAFTING NEW
REGS
LOS ANGELES - Los Angeles City Attorney Rocky Delgadillo has called
upon California Insurance Commissioner Steve Poizner and California
Department of Managed Health Care Director Cindy Ehnes to bring him into
any working group charged with crafting new regulations addressing
insurance policy cancellations, in order to protect California consumers
from the undue influence of health insurance lobbyists.
"We believe that unlawful practices are pervasive across the health
insurance industry, and it will take prosecutors, regulators, lawmakers,
as well as policyholders all working together to bring these companies
to justice and restore faith and fairness to America’s health care
system," said City Attorney Delgadillo, chief prosecutor for the City
of Los Angeles, in a letter issued yesterday.
"The process of rescission is not only illegal and potentially
criminal - it represents a moral stain on our State and our nation.
Working together, we can put a stop to these insidious practices," he
added.
The City Attorney issued his letter in the wake of reports that
insurance industry lobbyists are pressing state agencies to adopt
industry-friendly regulations at the expense of patients. While the
insurance companies purport to favor a "independent review process,"
in fact, the proposed regulations appear to strip consumers of
fundamental legal rights. The industry lobbyists have refused to
provide the actual text of their proposed regulations to the City
Attorney’s Office.
The City Attorney believes any independent dispute resolution process
must not eliminate remedies for patients, cannot apply to prior claims,
must be easy to understand and patient-friendly, and must be transparent
and open to public scrutiny. In addition, the City Attorney believes
that insurance companies should neither draft these regulations, nor
play a role in choosing the arbiter of these claims.
"Any independent dispute resolution process must be truly
independent," added Delgadillo.
Several months ago, City Attorney Delgadillo launched a broad
investigation into the health insurance industry’s unlawful, unfair,
and fraudulent business and deceptive advertising practices.
On February 21st, City Attorney Delgadillo filed a civil law
enforcement action against L.A.-based Health Net, Inc., and two of its
subsidiaries, for engaging in unlawful and deceptive business practices
that lead to denying or delaying the payment of claims or canceling
coverage after initially issuing a policy.
City Attorney Delgadillo also has launched a first-of-its-kind,
prosecutor-sponsored website - www.ProtectingTheInsured.org; the purpose
of which is to collect information from consumers, doctors, and
hospitals as part of the ongoing investigation into the potentially
unlawful, unfair, and fraudulent activities of health insurance
companies.
For more information, consumers are asked to visit
www.ProtectingTheInsured.org or City Attorney Rocky Delgadillo’s
website at www.lacity.org/atty .
About the Blogger
Larry Altman has covered crime in the South Bay since 1990. He's seen it all - the missing model who turned up dead in the desert, the wives found dead in trunks, the high-school coaches who get a little too close to their players. He drives his young colleagues nuts with his "I remember when" stories. He welcomes your tips and observations about the present, and you can mix in a little Lakers basketball talk if you like.
E-mail Larry at larry.altman@dailybreeze.com.
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