December 21, 2005
from the Insurance Commissioner's Office
Atlanta – Insurance Commissioner John W. Oxendine has signed a consent order directing United Healthcare Insurance Company, and sister companies United Healthcare of Georgia Inc., and Golden Rule Insurance Company, to pay a combined fine of $2.8 million for delaying payment on thousands of health claims.
“Paying health claims on time is not only good business, it’s the law in Georgia,” Commissioner Oxendine said. “Endless foot-dragging by companies is why we have a prompt-pay law on the books. I will aggressively pursue those who do not comply with that law.”
The fine total includes $2.3 million up front and an additional $500,000 which is suspended during a year-long probation period. The companies are also required to make changes to their claims payment practices. If the companies have no further violations during the probation, the additional part of the fine will be absolved, Oxendine said.
Last year Oxendine ordered a market conduct examination of United Healthcare Insurance Company after receiving numerous complaints regarding the company’s claims handling practices.
The exam revealed that the United Healthcare companies failed to pay between 75,000 to 80,000 claims in accordance with Georgia’s prompt pay law, which states that insurers must pay a claim within 15 working days, or explain to the consumer why there is a delay.
In 2000 and 2002 United Healthcare of Georgia Inc. was fined by Oxendine for similar offenses. By agreeing with the consent order, United Healthcare waives its right to a hearing.
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