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Consumer Watchdog sues insurance company for allegedly cheating LTC policyholders

February 9, 2012
by Kevin Kolus
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A health insurance company may not be honoring the long-term care policies of Californians, according to a new lawsuit filed by Consumer Watchdog and law firm Shernoff, Bidart Echeverria Bentley LLP.

The suit charges that Senior Health Insurance Company of Pennsylvania (SHIP)—which services policies that were originally sold by Conseco, American Travelers Life, Transport Life, United General Life and Continental Life Insurance Company—has allegedly told policyholders who file claims under their LTC policies that caregivers who come to their home must be licensed when licensing is not required.

The suit also alleges that SHIP has required policyholders to produce documentation not required by their LTC policies, and required policyholders to undergo “unnecessary” medical examinations by personnel selected by SHIP.

The plaintiff in the lawsuit, William Hall, 87, of Upland, Calif., is a former chief of medicine at a California hospital.

"Dr. Hall bought his policy in 1994,” an attorney with the Shernoff law firm stated. “But when he finally needed the care he was entitled to, SHIP delayed his claims for eight months, and even then paid only 20 percent of what SHIP owed Dr. Hall.”

According to the law firm, Hall spent “tens of thousands of dollars” to pay his home care workers out of pocket.

SHIP, which has not released a statement on the lawsuit, has about 10,000 long-term care policy holders in California.

The complaint filed, in San Bernardino Superior Court, is available from Consumer Watchdog here.

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