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Cinergy Health False Advertising Class Action Lawsuit Print Email
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Tuesday, 24 July 2012 03:00
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Cinergy Health False Advertising Class Action Lawsuit

By Mike Holter

 

Cinergy Health class action lawsuitCinergy Health & Life has been hit with a federal class action lawsuit claiming it continues to use “false and misleading infomercial advertisements” to push its medical coverage, despite receiving sanctions and fines from five states over the deceptive ads.

Lead Plaintiffs Harry and Rhonda Wiedenbeck allege in the Cinergy Health & Life class action lawsuit that Cinergy and American Medical & Life, which it markets itself through, offer “major medication coverage that in reality is extremely limited.” Advertisements for the health insurer claim the major medical coverage is offered with no exclusions for pre-existing conditions, but “consumers do not get the benefits or coverage advertised, and for which they paid,” the Wiedenbecks say in the class action lawsuit.

Cinergy and American Medical “intentionally played upon the vulnerabilities of people who either could not qualify for, or could not afford, traditional 'major medical' health insurance coverage by falsely presenting the American Medical policies as a low-cost way to obtain such coverage," the class action lawsuit says, adding that the companies habitually deny, delay and underpay claims – a pattern which is “the subject of numerous consumer complaints” in several states.

According to the class action lawsuit, this alleged pattern involves: "a) making it difficult for policy holders to determine which entity or which person within which entity was responsible for responding to or answering questions about claims; b) routinely denying claims by misapplication of the pre-existing condition limitation; c) singling out and misusing billing and diagnosis code information to misclassify claims as either excluded or subject to significant payment limitations under the policy; d) delaying response to claims and policy holder calls for weeks and months."

The Wiedenbecks say they discovered the true nature of the Cinergy, American Medical plan they bought when Rhonda’s hospital stay for stroke symptoms was not paid for, on the basis that it was for a "mental health" condition. The Wiedenbecks say they couldn't pay the out-of-pocket costs on time and calls they made to Cinergy and American Medical were left unanswered, so the bill was sent to collections.

The Wiedenbecks are seeking damages for themselves and a proposed class of all Wisconsin residents who purchased an American Medical Insurance policy marketed by Cinergy from March 1, 2009 to the present, as well as a subclass of these Class Members who incurred unreimbursed medical expenses on claims submitted under that policy.

A copy of the Cinergy Health Medical Plan False Advertising Class Action Lawsuit can be read here.

The case is Wiedenbeck v. Cinergy Health, Inc., et al., Case No. 12-cv-508, U.S. District Court, Western District of Wisconsin.
 

 

Updated July 24th, 2012

 

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Last Updated on Thursday, 27 December 2012 11:09

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