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New York insurance department finds health insurance companies not in compliance

Posted On Thu, October 14, 2010

Two health insurance companies are paying a hefty fine for violating New York's information rules. The state's insurance superintendent, James Wrynn, says the companies must pay $1.9 million for not being in compliance.

Health Net of New York and Health Net Insurance are being held at fault for not providing adequate information on their "explanation of benefit" forms, which are supposed to outline how a claim was made, processed, and any reasons for denial or partial payment.

Furthermore, the health insurance companies were also found to be at fault for taking too long to process claim payments.

"Consumers need clear information on how a health insurance claim was handled and what to do if they feel it was wrongly handled," says Wrynn. "These and other protections, including the right to be paid promptly, are built into our laws to protect consumers and we will enforce them vigorously."

This isn't the first time the New York Insurance Department has gone after health insurance providers. Earlier this month, the department fined Aetna $850,000, which was also found to be at fault for not including appropriate information on their forms.

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