Health Insurer Fined for Failing to Explain Coverage to Members

Oxford Health failed to explain service plans and appeals to its members, NY Superintendent of Financial Services said

Friday, Sep 21, 2012  |  Updated 10:50 AM EDT
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Insurer Failed to Explain Coverage, Fined: NY

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New York regulators say they've fined an insurer $665,000 for failing to explain health plan coverage to members, including ways to challenge claims they believe were improperly denied.

Superintendent of Financial Services Benjamin Lawsky says Oxford Health was cited for approximately 300,000 instances of not providing required statements about service plans and appeals from 2001 to 2008.
 
The fines apply to Oxford Health Plans NY Inc. and Oxford Health Insurance Inc. The companies were also cited for failing to provide regulators with timely and complete information.
 
In a settlement announced Thursday, Oxford has signed stipulations saying it will take steps to prevent recurrences.
 
 

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