NYAG Settles With Insurer

Jul 14, 2012

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.