Health Insurance Innovations is being sued by two different policyholders that claim they did not receive the insurance coverage they were promised. The policyholders are millions of dollars in debt due to the insurance plans lapse in coverage.
One individual spoke with a Health Insurance Innovations sales representative in 2016 that found an affordable option for her. The client said that the sales representative offered her a plan for $240 per month. She was very thankful and agreed to purchase the plan that she believed to be a traditional plan with coverage guarantees.
It wasn’t until much later that the client found out she had purchased a limited coverage plan instead of a traditional insurance plan. She was $48,000 in debt due to medical bills her insurance would not cover.
Another policyholder found out that his insurance would not cover the surgery he needed after paying premiums for two years.
This client purchased an insurance policy from Health Insurance Innovations that he believed to be full coverage. A few years later, he was diagnosed with a rare form of breast cancer that required surgery. Shortly before the surgery, the hospital informed him that his insurance would not cover the procedure. He needed to get the surgery anyway and was left with $40,000 in medical bills.
The insurance company may be at fault if the policyholders prove that they were misinformed by Health Insurance Innovations about which policy they were purchasing. In both cases, the clients believed they were being sold Affordable Care Act plans instead of the limited coverage plans they received.
Although the limited coverage policy sold by Health Insurance Innovations was not meant to cover catastrophic injuries, the company may be held responsible if they misportrayed information to prospective clients.
Health Insurance Innovations denies all allegations and says that the lawsuit has no validity. With $352 million in sales last year, the company plans to continue to sell health care policies and defend the accusations against them.