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HCC Medical Insurance & Other Short-Term Insurance Denial

HCC Medical Insurance Services is one of the largest providers of short-term medical coverage in the United States. In Arizona, and the rest of the U.S., subscribers have flocked to the company’s offerings with promises of low premiums and copays, fast enrollment process, and the advertised ability to use out-of-network doctors. Unfortunately, a quick Google search or perusal of the company’s BBB profile reveals not only unsatisfied customers, but also signs of rampant bad faith practices. There are many cases of HCC Medical acting in bad faith; refusing to pay a claim when it has no justified basis for denial or failing to properly investigate a claim. Surrano Law Offices is well-versed in litigating short-term insurance bad faith claims, as highlighted in a Bloomberg Businessweek article.

What Is Short-Term Health Insurance?

Since the induction of the Affordable Care Act (ACA) in 2010, short-term health insurance has been the route many Americans take when it’s the only option they can afford. It is available outside of the healthcare.gov marketplace and is not held to the same standards and requirements as those plans made available through the healthcare.gov marketplace. However, short-term health insurance promises to offer similar coverage to major plans that are part of the healthcare.gov marketplace, at a lower cost. But, as many testimonials from people who have had short-term health insurance reveal, the low monthly premiums don’t necessarily translate to adequate care. Some health providers act in bad faith towards their policy holders. And, in some cases, the low monthly premiums are not less than those offered elsewhere.

Short-term health insurance companies, such as HCC Medical, claim to offer affordable rates, quick approval, and flexibility in terms of how long you need it. If you’ve been laid off, or just need to fill a gap between major coverage if you change jobs, then you can get short-term coverage for anywhere from one month to one year. Hopefully you won’t even need to use the insurance in that short amount of time; and if you don’t, everything they promise holds true. If you do have to use it, high deductibles, few doctors from which to choose, and denial of compensation are common.

Why Do People Choose Short-Term Coverage?

In Arizona and throughout the country, the majority of people only buy short-term coverage because it’s cheaper, not necessarily because they need it. In 2014, the average individual and family premiums in Arizona were $103 and $199, respectively. However, the rate requests from providers in 2017 could see anywhere from an 11 to 65 percent premium increase, depending on which company you may be enrolling with.

When the ACA took full effect in 2014 (when penalties started being issued come tax time) the number of short-term enrollees doubled compared to the previous year. Although most sign up for the sole purpose of saving money, there are still a few things to watch out for when it comes to this type of medical coverage. In fact, most short-term plans don’t qualify as “minimum essential coverage,” which means you will still be charged a fee on your taxes. You are allowed two months of short-term or “gap” coverage before the tax penalty is levied against you.

Short-term insurance generally doesn’t cover “normal” care, e.g., doctor’s visits, routine check-ups, or even prescriptions. Beyond that, you may very well be denied if you have a pre-existing condition, even if that condition is relatively minor and/or something you’ve had since birth. You can, however, move to a plan which covers pre-existing conditions – defined as something that has been diagnosed or treated within the previous 3-5 years – if necessary. If that doesn’t happen, those low premiums usually mean high deductibles; the average short-term user paid $3,589 out-of-pocket.

The cons certainly seem to outweigh the pros when it comes to gap coverage. But most people who sign up for it don’t have a choice; they need to find the cheapest plan. Unfortunately, if they end up using it, the cost can be very high.

How Do Short-Term Insurance Companies Like HCC Act In Bad Faith?

All insurance companies owe a duty of good faith and fair dealings to their policyholders, and short term insurance companies are no exception. However, HCC and other temporary medical insurance provides have routinely found themselves proving the axiom: delay, deny, defend.  Insurance companies will use a variety of tactics in bad faith, including:

  • Automatically denying coverage
  • Failing to provide explanation for denying your claim
  • Delaying payment or information in hopes that the statute of limitations on your claim will expire
  • Post-Claim Underwriting: Waiting for you to file a claim before investigating your application, then finding a reason to void your policy
  • Claiming a procedure is “not medically necessary”
  • Tying a new illness or injury to an unrelated pre-existing condition

Mistreated HCC policyholders have made their voices heard online. It’s not just a few smatterings of customer complaints; there is a consistent and noticeable trend when it comes to short-term providers acting in bad faith. HCC Medical seems to be a heavy culprit in this regard, although certainly not the worst, as the Better Business Bureau has logged 115 complaints from HCC customers over the past three years. Some of the complaints show awful accounts of losing or being denied coverage when it’s needed the most.

One mother, whose 3-year old daughter broke her leg, tried to submit the claim to HCC. She sent in all the proper forms and paperwork, and despite being assured she would be covered, ended up being denied. When she placed a call to HCC, they refused to talk to her, because she is not the patient. The patient was 3 years old. On top of this, HCC tried to claim that they never received any paperwork from her. After lodging a complaint with the BBB, the matter was finally resolved.

Most, if not all, of the complaints revolve around this; denial of claim due to either pre-existing condition or pretending like they never received the proper forms, even though you may have confirmation from the shipper. It’s bad enough that you have to deal with an injury or surgery and recovery, but it should not take months of phone calls and complaints in order for them to so much as process your claim.

Is HCC the Only Offender in the Short-Term Insurance Industry?

As previously mentioned, HCC is not the worst company offering short-term healthcare, and it’s far from the only one in Arizona. United Health One, National General, and IHC Group are shown along with HCC, while Blue Cross/Blue Shield, and AAA offer short-term options for health insurance as well. United Health is a very large company with many smaller insurance branches under its tree, and among Arizona’s options, it is rated by BBB as the worst provider in the state. The Bureau has logged over 1,200 complaints in the previous three years regarding United Health, mainly for dragging their feet on processing a claim or not providing the enrollee with proper coverage.

What Happens If I’m a Victim Of Bad Faith Practices?

If you find yourself in this unfortunate situation, speaking with a short-term insurance bad faith attorney should be your first step. This will let your health insurance company know that you are serious, and no amount of run-around can get you to give up on having your claim approved. If this still doesn’t get them to respond, then you may be entitled to far more compensation than what the original claim sought in the first place.

It doesn’t take much for a bad faith claim to be justified. If it comes to a lawsuit, your attorney fees as well as emotional damages endured by going months without claim coverage and paying thousands of dollars out-of-pocket can all be compensated. When a lawsuit is necessary, it’s important you find an attorney who has the experience and expertise to handle your case.

We Will Fight For You

Perhaps the most unfortunate thing about insurance scams is that they are nothing new. The Surrano Law Offices has won millions of dollars in lawsuits and settlements for people who have been mistreated. If you feel you are being swindled by HCC Medical Insurance Company or any other short-term health insurance provider, we can make sure you are justly compensated.

Contact us today at 602.264.1077 – your initial consultation is free and our dedicated associates will give your case undivided attention to ensure you are treated fairly by the insurance company.