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Posts Tagged "fraud"

Is HumanaOne Playing Games With Florida Health Insurance Coverage?

Posted by on Sep 16, 2013 in Uncategorized

Is HumanaOne Playing Games With Florida Health Insurance Coverage?

We recently heard from a Florida insurance consumer who had become quite frustrated with his health insurance company, HumanaOne.  I thought it might be useful to share this person’s story, so that maybe other Floridians won’t get tricked by HumanaOne — or any other health insurance company — in the same way that this gentleman apparently has. The story of this gentleman — we’ll call him “Bob” — started out innocently enough.  Bob recently relocated to Central Florida, and contacted an insurance broker he found from a website to assist him in securing some health insurance.  Based upon Bob’s needs, the broker suggested HumanaOne, a subsidiary of Humana Health Insurance of Florida.  Humana requested some additional information from Bob, and Bob provided it. A few days latter, Bob received a Medical Proof of Coverage form from HumanaOne indicating that effective date of coverage was May 1, 2013.  He also received letter from HumanaOne indicating that his coverage was going to start on May 1, 2013, and that he would have his monthly premium payment automatically drafted from his bank account on May 1, 2013. Bob then did what most people would do – he started making appointments to see doctors after May 1, 2013.  Bob saw several doctors in the first week or so of May 2013, and presented his HumanaOne insurance information to each doctor’s office.  Bob thought everything was fine until he started getting notices from his doctors that HumanaOne was refusing to pay their bills. What Bob did not know — and what nobody at HumanaOne or his insurance agent’s office told him — was that the fine print of Bob’s HumanaOne policy says that only bodily injury-related medical bills would be paid starting on May 1, 2013.   What nobody told Bob was that illness or sickness-related bills would not be covered until May 16, 2013. As a result of not knowing or being told this, not only is HumanaOne not paying Bob’s bills, but HumanaOne is also considering all diagnoses made between May, 2013, and May 16, 2013, as pre-existing conditions.  This means HumanaOne may not have to pay for any bills related to those conditions for another year. As an Orlando accident attorney, I believe HumanaOne is being incredibly unfair to Bob.  I also think there is an argument that Bob was induced to purchase this coverage from HumanaOne under false pretenses or as the result of fraud.  Florida has strong laws against unfair and deceptive trade practices that very well may apply to this situation with HumanaOne. What do you think?  Does this situation sound right to you?  If you are facing a similar situation with HumanaOne, or any other health insurance company for that matter, contact Winter Park personal injury lawyers Kim Cullen and Robert Hemphill at...

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Lying About Your Injuries? Florida Accident Attorney Says Please Seek Assistance Somewhere Else

Posted by on Jun 13, 2013 in Uncategorized

Lying About Your Injuries?  Florida Accident Attorney Says Please Seek Assistance Somewhere Else

Insurance companies would have the public believe that every personal injury law firm has a file drawer full of clients who are faking their injuries or staging accidents in order to become injured. Not only are insurance companies mistaken, but I can assure you that nobody dislikes fakers and frauds more than professional, well-established personal injury attorneys and their legitimately injured clients. This was driven home for me by a piece I recently saw on the ClickOrlando.com website. The article was about a supposedly injured U.S. Postal Service worker who was recently found guilty of defrauding the federal Workers’ Compensation program by faking an injury. The postal worker had insisted that she could not stand, sit, kneel, squat, climb, bend, reach or grasp. Meanwhile, she was seen zip-lining on a cruise vacation, as well as appearing on television on the Price Is Right game show and spinning the “Big Wheel” there. I have absolutely no sympathy for somebody like the postal worker described in this story. Not only is a person like this clearly committing a crime, but she is also ruining the justice system for other people at the same time. When members of the public (i.e. potential jurors) hear stories about people committing these kinds of crimes, it understandably raises their level of skepticism about every person claiming an injury. This kind of heightened — sometime almost unreasonable — skepticism makes my job as a Florida accident attorney more difficult, and it makes it more difficult for truly injured people to achieve a fair result in the legal system. This is why nobody dislikes fakes and frauds more than we (and our clients) do. If you have a real injury from an accident that actually happened, and you have questions about your claim or legal rights, call Winter Park personal injury attorneys Kim Cullen and Robert Hemphill at...

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