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Insurance company gives refunds for wrongly denied claims

Make sure your insurance company handles your deductibles correctly.

After consumers complained about their deductibles not being calculated accurately, the New York State Attorney General’s Office launched an investigation of Excellus Bluecross Blueshield.

Excellus has agreed to refund plan members who overpaid health care providers as a result of Excellus's improper accounting of deductibles.

The settlement also requires Excellus to properly account for members' deductible and out-of-pocket expenses to prevent similar denials of claims in the future, New York Attorney General Eric T. Schneiderman said today in a statement.

The company has made payments totaling about $3.1 million to consumers and providers.  

After Excellus wrongly denied claims, providers either billed the customers for the cost of the services or absorbed the loss themselves. Excellus reported that the accounting errors – which affected 12,000 customers – were the result of a technology glitch after its software was modified.

Copyright 2012, Rita R. Robison, Consumer Specialist

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