Health policy scams studied

BY VALLERY BROWN Modified: March 8, 2010 at 4:22 am •  Published: March 8, 2010

The U.S. Capitol building at his back and a flag at his flank, an insurance company spokesman pitches a so-called Cadillac health care plan for a compact car price.

"Most importantly, you get peace of mind knowing you and your family have health insurance and now at a rate you can afford,” the spokesman promises in the online commercial.

For 60-year-old Glenda Hey, peace of mind wasn’t a part of the package.

After nearly a year of paying $314 per month in premiums to Springfield, Tenn.-based American Trade Association, Hey learned the company had no intention of paying her health care costs.

Now, at a time when they should be planning to retire, Hey and her husband are trying to figure out how to pay the more than $32,000 she owes her hospitals and doctors.

"I was doing the right thing. I had insurance I thought would cover me,” Hey said. Plans of settling into retirement and enjoying her children and grandchildren have turned into discussions about tapping into retirement savings to pay medical bills.

Hey went to the hospital last March with shortness of breath and chest pains. A few months after the emergency room visit, Hey learned the claims were denied by ATA. After months of appealing the decisions and getting no response, the company canceled her policy and left Hey to pay the bills.

Hey called the state Insurance Department and learned she had bought what many insurance regulators are calling a scam insurance policy.

State investigations
Insurance Commissioner Kim Holland said the company was operating in Oklahoma without proper licensing. At least 20 other states are investigating. She said ATA and its unlicensed third-party-administrator, Smart Data Solutions, fax advertisements and use unlicensed agents and the Internet to market plans.

"The bottom line is there is no insurance. They are providing materials that claim to have insurance, taking money and not paying claims,” she said.

The company has collected about $14 million in premiums nationwide, Holland said. More than 12,000 people, including as many as 100 in Oklahoma, have signed up for the plan.

"They are still around,” Holland said. "What they’ve done is moved from area to area and product to product to avoid regulators.”

Documents from Tenn-essee show ATA officials have admitted to not having underwriters.



Cease and desist

Individuals and companies alleged to be affiliated with or working for American Trade Association on state cease and desist orders:

→Real Benefits Association

→Smart Data Solutions

→Serve America Assurance

→Healthcare America

→Superior Healthcare

→Omni Healthcare

→Obed Kirkpatrick

→Bart Posey

→Beema-Pakistan Co.

More information
The state Insurance Department encourages all consumers to call and confirm any company or insurance agent offering insurance or insurance-like products are properly licensed to do business in Oklahoma. They can do this by calling the Oklahoma Insurance Department at (800) 522-0071 or by visiting www.oid.ok.gov.

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