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Class Action Topics: Insurance Fraud

Insurance Fraud Lawyer

Chicago Group Health Insurance Lawyer Protecting Consumers from Over-Billed Out-of-Network Charges and Insurance Fraud

If you are sick or injured and need medical treatment, you typically have the option to select an out-of-network physician to provide care, with the knowledge that you will pay a higher percentage of the cost than if you had chosen an in-network physician. Your insurance company, however, still has obligations to reimburse you for the percentage of the cost that is outlined in your policy and to appropriately calculate charges for medical treatment. When your company does not adhere to their obligations, it can cost you a substantial amount through over-billed out-of-network charges.

At Complex Litigation Group LLC, in Chicago, Illinois, we represent clients from around the country in class action lawsuits and complex litigation. We provide policyholders with a voice against group health insurance companies who have engaged in fraudulent business practices, including over-billing for out-of-network medical care. Since 1999, our attorneys have recovered hundreds of million dollars in state and federal courts. Through class action litigation, our goal is help our clients recover the compensation that they deserve and to expose fraudulent practices in the health insurance industry.

If you believe that you were over billed for out-of-network medical care, contact us at Complex Litigation Group LLC and speak with us about your situation. Call us toll free at 866-779-9610.

Underestimated Medical Costs and Out-of-Network Fees

Group health insurance plans require that patients pay a higher percentage of the cost of out-of-network care in order to deter policyholders from choosing more expensive medical care. These companies purposely understate how much some medical treatments and other procedures typically cost and leave policyholders to pay the difference.

For instance, if doctors in a geographical area charge $150 on average for an office visit, the typical plan will cover 80 percent of that amount. However, the insurance company may calculate the charge for a visit at only $80, which means the company would only reimburse $64 of the charge. Therefore, the patient would be stuck paying $86 of the original $150 fee. The insurance company, in effect, has only covered about 42 percent of the office visit, despite the policy stating that it will pay 80 percent of the cost.

These discrepancies are large and put the onus on patients to pay for high medical bills that should have been covered by their insurance companies. At Complex Litigation Group LLC, we do not believe that policyholders should have to pay extra due to intentional miscalculations by their insurance companies. This is a form of group health insurance fraud and companies that engage in these activities should be held accountable for their fraudulent practices.

Contact Complex Litigation Group LLC to Learn More Information

As a policyholder, you have a right to expect that the provisions in your plan will be followed by your group health insurance company and that you will not have to be responsible for high bills you did not expect to pay. Contact us by e-mail or call us anywhere in the country at 866-779-9610 to speak with a lawyer at Complex Litigation Group LLC.

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Contact Complex Litigation Group LLC

Complex Litigation Group LLC
513 Central Avenue
Suite 300
Highland Park, Illinois 60035
Toll Free: 866-779-9610
Phone: 847-433-4500
Fax: 847-433-2500
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