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PHONY HEALTH INSURANCE PLANS ON RISE IN U.S. - STUDY

WASHINGTON (Reuters) - Phony health insurers are pocketing millions of dollars in premiums while leaving their victims with huge, unpaid medical bills, according to a report released on Thursday. Such scams are on the increase because of rises in legitimate premiums, according to The Commonwealth Fund, a New York-based independent foundation studying health policy that published the report.

"The United States is experiencing an unprecedented influx of unauthorized insurers selling phony health insurance," the researchers wrote. "Unauthorized health insurance companies intentionally fail to comply with state and federal law regarding insurance regulation; they collect premiums for nonexistent health insurance; they do not pay claims and, ultimately, they leave patients with millions of dollars in medical bills," they added. Since 2001, four unauthorized plans left nearly 100,000 people with $85 million in medical bills. "Most victims have been small businesses and self-employed people," reads the report, which is on the Internet at http://www.cmwf.org/.

"Being victimized by a phony health insurance scam is worse than being uninsured," Mila Kofman of the Health Policy Institute at Georgetown University, who led the study, said in a statement. "Here, not only are you stuck with huge medical bills, you've also been defrauded thousands of dollars in premiums." Kofman and colleagues interviewed state insurance commissioners, insurance regulators, the Employee Benefits Security Administration -- part of the U.S. Department of Labor -- and other agencies for the report. They said Florida was especially hard hit, with 30,000 victims of such scams.

The scams exist, they said, because health insurance is expensive and difficult for many people to get. "One unauthorized plan, for example, charged a 50-year-old woman a monthly premium of $285 -- an unusually low rate," they wrote. A more realistic fee would have been $425 a month, they said. Many avoid suspicion by paying small claims, but they delay payment on big ones. Because doctors are used to having to wait, they may not immediately become suspicious.

 

 

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