Maine Insurance Superintendent Eric Cioppa Announces Anthem Health Plans of Maine to pay $225,000 Civil Penalty for Untimely Complaint Handling

January 9, 2017

 

Contact: Doug Dunbar
Phone:

 

Augusta -

Maine Insurance Superintendent Eric Cioppa announced that Anthem Health Plans of Maine, Inc. (“Anthem”) has agreed to pay a $225,000 civil penalty as part of a consent agreement following an investigation by the Maine Bureau of Insurance into the company’s complaint handling procedures. In addition to the civil penalty, Anthem is required to submit a corrective action plan to the Bureau within thirty days of the agreement.

The Bureau’s Market Conduct Unit performed a comprehensive review of Anthem’s complaint handling after Bureau investigators reported several late and missing responses to complaints forwarded to Anthem by the Bureau.

The exam found that the company repeatedly failed to comply with Maine law, requiring insurance companies to respond to the Bureau’s consumer complaint inquiries within 14 days. The examination also found that the company failed to accurately report some annually required data and failed to facilitate a timely completion of the examination.

“We expect insurers to respond in a timely and substantive manner to issues raised by consumers,” Superintendent Cioppa said. “Failure to respond to the Bureau’s inquiries is a serious issue, as it directly impacts our ability to assist consumers and protect their contractual and legal rights.”

Cioppa also stated that the Bureau will be reviewing Anthem’s corrective action plan and will continue to monitor the company’s handling of complaints, to ensure that the corrective action has resolved the issue.

Anthem is a Maine domiciled insurance company based in South Portland. The Bureau was assisted in the investigation and settlement of the consent agreement by the Maine Attorney General’s Office.

The Bureau’s staff is available to answer consumer’s questions Monday through Friday from 8 a.m. to 5 p.m. by dialing 1-800-300-5000 or 207-624-8475 (TTY please use Maine Relay 711). Consumers may also email questions to insurance.pfr@maine.gov.

Last Updated: January 12, 2017 2:13 PM