For Immediate Release:	Contact:
June 11, 2008	Chrissy Pearson
	Kristin Milam
	(919) 733-5238
Conseco, Bankers Life Customers May be Due Claims Review
A Pattern of Problems Leads to a Multi-State Agreement Regarding Long Term Care Claims
RALEIGH -- Insurance Commissioner Jim Long today urged consumers with a long term care insurance policy from Conseco Inc. to be aware of a recent multi-state settlement that could result in adjustments made to past claims. The settlement, which arose after regulators uncovered a pattern of problems with the company, resulted in a $2.3 million fine and an additional $30 million in claims-handling improvements and restitution. North Carolina's share of the fine is $41,774.
The settlement involves two Conseco subsidiaries - Conseco Senior Health Insurance Company and Bankers Life and Casualty Insurance Company - and covers claims filed from Jan. 1, 2005, through April 30, 2007.
Consumers who filed a claim with either of these two companies which was later denied may be eligible for a review and reversal of that denial. Policyholders should call Conseco at 1-866-452-6589.
Regulators found that:
Investigations of pending claims were not handled in a timely manner; Claim files were not properly documented or maintained; and Timeframes for company responses to claimants did not adhere to applicable regulations.
According to the terms of the settlement, Conseco Senior Health Insurance Company, which is not actively writing new policies, will automatically review 1,112 claims that were initially denied; it will provide notices to another 18,000 policyholders covering 49,000 claims that may have been partially denied or subsequently denied after initial payment; and will set up a toll-free call center for all claimants who believe their claim settlement was not handled properly. The multi-state investigation found that the primary problems in most cases were delays in claim payments rather than outright claim denials.
In the case of Bankers Life and Casualty Insurance Company, which is writing new policies, the investigation uncovered inadequate marketing and sales compliance issues.
This multi-state examination was coordinated with the National Association of Insurance Commissioners' (NAIC) market analysis working group and was conducted on behalf of more than 40 participating states.
-- NCDOI --