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NYAG Settles With Insurer

NEW YORK (WAMC) - Attorney General Eric T. Schneiderman has announced a settlement with AXA Equitable Life Insurance Company, after an investigation revealed that the corporation made an undisclosed change to its medical claim reimbursement policy resulting in lower reimbursements for many members.  WAMC's Dave Lucas has details
 

The Attorney General's Health Care Bureau found that beginning in September 2011, and continuing through May 2012, despite the policy's terms of reimbursement at the usual and customary rate, AXA Equitable used data from a third-party to reimburse medical claims affecting several hundred consumers.  The switch resulted in lower medical claim reimbursements for many members than had been the case previously.

AXA Equitable has agreed to reimburse consumers in an amount that could reach almost $850,000.  Within 60 days of the signed agreement, AXA Equitable will mail members information on how they can submit a claim for restitution.

As a result of the investigation, AXA Equitable has already changed its medical claim reimbursement policy to honor the terms of its members' health insurance plans.

Dave Lucas is WAMC’s Capital Region Bureau Chief. Born and raised in Albany, he’s been involved in nearly every aspect of local radio since 1981. Before joining WAMC, Dave was a reporter and anchor at WGY in Schenectady. Prior to that he hosted talk shows on WYJB and WROW, including the 1999 series of overnight radio broadcasts tracking the JonBenet Ramsey murder case with a cast of callers and characters from all over the world via the internet. In 2012, Dave received a Communicator Award of Distinction for his WAMC news story "Fail: The NYS Flood Panel," which explores whether the damage from Hurricane Irene and Tropical Storm Lee could have been prevented or at least curbed. Dave began his radio career as a “morning personality” at WABY in Albany.