When it comes to insurance policies, an insurance company should strive to be as clear and concise in the language printed in the policy. More importantly, if changes are being made to a current policy, that language should also be as clear and concise as possible for the policy holder. Unfortunately, it seems Anthem has missed the mark in clarity according to a recent class action lawsuit.
According to a post published on the consumerwatchdog.org at the beginning of November, Anthem Blue cross has found itself in a bit of hot water with several of its policy holders. The post notes the announcement of a lawsuit against the insurance giant to try and prevent it from cancelling out “individual PPO health plans in California”.
Of course, the devil is in the details and in this situation it seems that the renewed coverage for 2017 would not provide coverage for out of network physicians.
Now while we primarily focus on property insurance issues, and this problem is primarily health insurance based, there is a bit of overlap.
Kevin Pollack at Property Insurance Law Blog provides some context in one of their latest blog posts. He points out how if the coverage is reduced or has certain aspects removed (the out of network physician coverage in this case), this must be communicated in a clear manner to the policy holder or else the insruance company could be held liable by the courts.
When it comes to property insurance, companies must provide notice of a change “at least 45 days prior to policy expiration”. They also must be as clear and concise as possible when describing the changes a policy might see.
How do they do that?
“a heading in capitals . . . larger type than the surrounding text, or in contrasting type, font, or color to the surrounding text of the same size . . .”
Pretty simple, right?
Unfortunately, Anthem lacked the foresight to clarify the changes to their policies before sending out the renewal notices. Hopefully the end result will encourage other insruance companies whether they’re health care or property to properly word poicy changes so that customers know what’s happening.
What do you think? Do changes to policies need to be clear and concise?