An Oklahoma jury ordered American Fidelity to pay $10.8 million for improperly reducing the benefit owed to the mother of a policy holder who died. Dolores Metzger claimed the company improperly changed its policy for paying “actual charges” for limited benefit health insurance policies, such as the cancer policy purchased by Metzger’s son. Before 1994, American Fidelity paid whatever the patient was billed. In 1994, American Fidelity began paying only the often-discounted amount that health care providers charged insurance companies.
The company, in court documents, admitted that it changed its definition of “actual charges” in 1994. But American Fidelity denied that it violated Oklahoma law or public policy or that it acted in bad faith.
This is the standard MO for insurance companies, they have no heart to do the right thing. Whether is your uninsured motorists coverage from an auto wreck, health insurance et. al., you can never, and I repeat never count on an insurance company to do anything other than what benefits there bottom line.
To read the Oklahoman article, who is unabashadly pro-tort reform, just remind yourself that this is the equivalent to Jeffrey Dahmner’s attorney saying he was innocent. Its just representation. I will warn you, this article is written in a pro-tort reform stance with little credence given to the suffering parents and what the award was based on.