Health Insurance Scams:  How to protect yourself

Crime invades every spectrum of life in the United States and around the world and sadly, even people trying to protect them and their loved ones from health-related financial burden are at risk. Federal statistics show a steep rise in the number of fraudulent or unlicensed health insurance companies in recent years. The result? Hundreds of thousands of Americans spent their money on what could be worthless health care coverage that should have been worth more than a quarter billion dollars. Most of the bogus insurance is provided through employer-sponsored programs where scurrilous shysters have access to hundreds of potential victims, or to self-employed workers and small businesses that may not be able to afford or participate in a decent group plan.

It has been suggested that the high cost of health care benefits in the United States has contributed to the rising number of health insurance scams. With more than 40 million Americans living without any kind of health care insurance, fraudsters have a huge market of people who want to think they are getting a deal on a service that offers medical protection for their families. In fact, a Georgetown University study found the dramatic increase in medical care insurance scams has risen at the same time health care insurance premiums have recorded double-digit rate hikes.

Often, the scam does not reveal itself until after one of these unfortunate beneficiaries tries to use their health insurance to cover an approved medical situation. By then, depending on the family’s ability to pay for medical services without insurance, a financial crisis may already be in the works. State governments tend not to offer guarantees or financial protection when health care insurance plans are revealed as a swindle or if the insurance provider is unwilling or unable to pay for legitimate claims.

Despite the awfulness of perpetuating such a horrible crime, fraudulent health insurance companies often get away with their stolen money intact. Authorities are unable to simply swoop in and arrest the bad guys; investigations take time and organization if they are to succeed in getting enough evidence to bring about a guilty verdict in court. Unfortunately, by the time such an investigation can be mounted and authorities can make a move, fraudulent health insurers have had a chance to hide their assets or have moved on to another location under another name.

There are several things that may make you suspicious about the legitimacy of a health insurance provider. First among these is price. Fraudulent medical insurance companies tend to offer cut-rate prices as a way of luring victims to hand over their money. The truth is that health insurance can be a pricey prospect. If you think you’re getting too good of a deal, you’re probably not getting a deal at all. As the old adage goes, if something seems too good to be true it probably is.

A second indicator that the health insurance provider you are dealing with might be a scam operation is the presence of less than usual or even the absence of the regulations that govern other insurance providers. Fraudulent health insurance plan providers also try to attract potential clients by boasting about regulatory freedom at the state level. Don’t be fooled: legitimate health insurance providers are not immune from state regulation. Quite the opposite is true. Many types of insurance, including health care insurance, are regulated primarily by each state.

Additionally, while health care insurance fraud is a nation-wide problem, a survey of some of the identified medical insurance scams has revealed Texas and Florida as particular hotbeds of fraudulent insurance activity. Beware of any health care insurance providers that have recently started business. Check with your better business bureau to make sure there have been no complaints.

There are some things you can do to protect yourself against fraudulent health insurance plan scams. The first thing you can do is be aware that bogus plans are out there. The second step you take to protect yourself while still getting a reasonable health care insurance plan is to educate yourself about your available options: shop around, ask questions, request proof of licensing (operating an unlicensed insurance operation is illegal in every state), get recommendations and contact a state insurance commissioner to verify the legitimacy of a health care insurance operation before you sign anything.