Insurance Dept. Claws Back $2.4M In Three Months, Healthcare Advocate Generates $2.4M In Savings
In the second quarter of the year, the state Insurance Department clawed back a total of $2.4 million from insurance carriers for various violations and settlements, Insurance Commissioner Thomas Leonardi announced Thursday. During the same period, the Office of the Healthcare Advocate generated $2.4 million in savings, according to a separate press release.
From April through the end of June, the consumer protection arm of the department helped policyholders address around 1,600 complaints and recouped about $906,000, according to a press release. Meanwhile, the Market Conduct division imposed more than $1.5 million in fines on carriers for violations including late claim payments and improper licensing. Money collected for the fines were returned to the state’s General Fund.
“Every day we assist consumers in making informed decisions and understanding their policies. The department’s comprehensive reviews of company business practices and enforcement of state laws help ensure that policyholders are treated fairly and rightfully reimbursed for insured losses,” Leonardi said in a statement. “Department examiners have a wealth of expertise in all types of insurance and their advocacy on behalf of consumers gets results.”
The Insurance Department has recovered more than $4 million from carriers, which was either returned to policyholders or the state, Leonardi said.
According to the department, the breakdown of funds returned to policyholders in the second quarter were as follows:
- Accident, Health - $542,958
- Auto - $94,853
- Fire and Commercial - $490
- General Liability - $34,310
- Homeowners, Farmers - $190,667
- Life, Annuities - $32,382
- Miscellaneous - $10,418
Meanwhile, State Healthcare Advocate Victoria Veltri also issued a statement Thursday, saying her office generated $2.4 million in savings for consumers in the second quarter. Those savings came from services and claims that would have been paid by healthcare consumers, if the office hadn’t intervened.
Veltri said the agency has an 85 percent success rate in overturning carrier denials of coverage despite remaining at a two-year high for case load volume.
Denials of coverage in cases involving mental health care and drug abuse treatment dominated the healthcare advocates caseload for the quarter, according to a press release.
“Access to mental health and substance use treatment for privately insured Connecticut residents is a critical problem that we can no longer ignore. OHA is committed to ensuring that insurance companies are held accountable to their consumers for ensuring access to care and coverage—coverage that consumers pay for in their premium dollars—for medically necessary treatment under state and federal mental health parity laws and grievance and appeals regulations,” Veltri said in a statement.
Donna Tommelleo, a spokeswoman for the Insurance Department, said it was pure coincidence that both agencies issued statements touting a $2.4 million figure for work over the same period.