Phony health plans are sweeping the U.S. in a crime wave that should put every agent on alert. Now is the time for agents to enhance their value by educating consumers about the red flags of fraud.
Scammers are peddling junk to your clients and prospects. The sellers generally have no producer licenses and are selling unauthorized coverage.
Con artists are promising full-benefit health coverage but delivering worthless pieces of paper, stripped-down, low-benefit policies or medical discount cards that are basically buyer clubs for discounted services for which people still must
pay themselves.
Hucksters have exploited people's vulnerability in the downturned economy for more than 2 years. Millions of Americans have no health insurance. Widespread layoffs and high health premiums amplify people's willingness to believe a smooth sales pitch. Here are two real-life examples:
o Bob Harper unknowingly bought fake coverage. His heart then went bad and he urgently needed a pacemaker operation. But the Oklahoma man discovered his coverage was useless, and legitimate insurers were turning him down because of his preexisting condition.
o Mary Lloyd's husband, Anthony, had a serious heart attack after they bought what the Minnesota couple thought was a better plan than their then-current health policy. But the new plan wouldn't pay his bills. They were left with at least $67,000 in expenses and a financial nightmare.
Overall figures on total victims, stolen premiums and unpaid medical bills have yet to be compiled. But the cons likely are operating in most states–actually all states, because some bogus plans have borderless websites. And just one outfit–American Trade Assn.–has stolen $14 million from 12,000 people nationally, regulators estimate.
More come-ons also sprouted right after healthcare reform passed. They exploit consumer confusion about what reform means. Some swindlers are going door-to-door. They're lying that they're from the federal government and that consumers are “required” to buy “ObamaCare” coverage immediately. “Limited-time” deals for as low as $29.95 a month are being peddled, and prospects are urged to buy in right away.
The Coalition Against Insurance Fraud has mounted a national news campaign and issued a detailed consumer alert to help the public and policymakers understand the trend, the dangers and red flags. NAIC is active and so are many insurance departments. U.S. Dept. of Health and Human Services Secretary Kathleen Sebelius has issued a national alert about the healthcare-reform cons.
Agents also have a stake in actively warning the public. Your personal and commercial clients and prospects are being solicited. Some are giving up valid health coverage, believing they've found a better deal. Beyond your lost clients and commissions, fake health plans should trigger heightened concern for the well-being of the public you serve.
Partner with your insurance department and other state insurance groups. Include alerts on your websites, and in client newsletters and social media marketing.
The Nevada Independent Insurance Agents (NIIA) has teamed with the state insurance department and another insurance group on statewide outreach campaigns.
NIIA President Kay Lockhart detailed the upheaval caused several years ago by an unlicensed health plan called Employers Mutual, which took its name from a legitimate carrier to confuse its victims.
“That heavily impacted the State of Nevada. Consumers and larger businesses were scooped up. They had no coverage for themselves or their employees and they had to pay for coverage themselves,” Lockhart recalled. “Our members lost a ton of money on it because they lost the clients, and our clients lost a ton of money because they had to pay hospital bills themselves.”
Licensed agents who sell fake health coverage also face career-threatening legal problems. Do your due diligence if approached by a suspect outfit. The tempting commissions aren't worth it: When the inevitable crackdowns occur, involved producers face loss of their licenses, plus large fines, client lawsuits, possible criminal prosecution and destruction of their careers.
Shady health plans are more sickening than the medical conditions they purport to cover. It's time to inject a cure.
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