Insurance Department Fines Conseco Under Pennsylvania-Led, Multi-State...( Market Conduct Examination Finds ...),Health

Market Conduct Examination Finds Serious Violations in Long-Term Care Insurance Market

HARRISBURG, Pa., May 7 /PRNewswire-USNewswire/ -- Acting Insurance Commissioner Joel Ario today announced a 40-state settlement with Conseco Inc., which was necessary due to a pattern of consumer harm in the company's long-term care insurance business.

The Pennsylvania Insurance Department led the multi-state investigation, which resulted in a $2.3 million fine and an additional $30 million in claims-handling improvements and restitution.

"Conseco is among the nation's largest long-term care insurers," said Ario. "It is vital that long-term care insurers make prompt and appropriate payment of claims to consumers who are older and whose lives and well-being are dependent upon it. Conseco failed this test.

"The company will pay $32 million, primarily for claims-handling improvements and restitution to consumers who were harmed. Affected policyholders will have the opportunity to have their claims re-evaluated."

The on-site examination showed that:

-- Investigation of pending claims were not handled in a timely manner;

-- Claim files were not properly documented or maintained; and

-- Time frames for company responses to claimants did not adhere to

applicable regulations.

The settlement involves two Conseco subsidiaries -- Conseco Senior Health Insurance Company and Bankers Life and Casualty Insurance Company -- and covers claims filed from Jan. 1, 2005, through April 30, 2007.

Conseco self-reported serious issues in complaint and claims handling and blamed the problems on the challenge of integrating various computer systems. The settlement requires the company to contract with an experienced long-term care claims administrator to process claims in a timely and appropriate manner.

According to the terms of the settlement, Conseco Senior Health Insurance Company, wh
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