Conseco Senior Health Insurance Company, which is under new management and is now called the Senior Health Insurance Company of Pennsylvania, had been the subject of numerous consumer complaints to the Department which discovered that Conseco was improperly denying claims on long term care policies and that its claims handling practices were confusing and onerous. The average age of Conseco Senior's policyholders is 80.
In response to numerous complaints, the Commissioner conducted an on-site market conduct examination that uncovered additional poor claims handling practices that violated California law, and uncovered coverage denials that were based on a misreading of federal law.
The Commissioner also determined that Conseco Senior was misapplying the terms of its policies and was denying benefits.
Under the settlement agreement, Conseco Senior will pay a $500,000 penalty and will retroactively readjust certain policyholder claims back to Jan. 1, 2004, which will be paid with interest.