Senior Health Insurance Company of Pennsylvania - SHIP improperly denies claims

Posted on Saturday, August 13th, 2011 at 11:16pm CDT by 48506592

Product: Long Term Care Insurance

Company: Senior Health Insurance Company of Pennsylvania

Location: PO Box 64913
St. Paul, MN, 55164, US


Category: Other

Open Letter sent to US Congressmen on August 13, 2011:

I own a home care agency. I have recently had to have dealings with a long term care insurance company named Senior Health Insurance Company of Pennsylvania (SHIP). One of our home care clients is insured by them.

SHIP has denied claims to our client for ridiculous, unsupportable reasons. As a result, I started a process to file an official complaint with the State of PA. As I searched for information about SHIP, I found that in recent years they have been fined, ordered to pay restitution to their customers... in very large $ amounts by multiple states due to improper denial of claims, extreme delay in claims payments, and more. The records available online seem to show that this company has far more complaints against it per $ insured than the next worst company operating in the United States. After a reorganization a few years ago that was needed to address financial issues, claims problems, and operational problems, it appears they continue to use many of the same personnel that were involved when claims were mishandled in the past.

I believe that this company is committing a form of fraud by selling people policies that they don't honor. SHIP operates nationwide. Based on my experience, it seems to me that there must be intent on their part to commit fraud. No one that understands home care regulations could possibly take the positions they are taking relative to our client's claims.

I request that a Federal Criminal Investigation be launched. The history of this company is clear. The statistics alone indicate a serious problem. Please help bring those involved at SHIP to justice, and help their customers receive their rightfully-due claims.

1 Comment

joni l., 2015-02-26, 06:04PM CST

My Mom died on September 10, 2014. We discovered she had a policy with Senior Health Insurance of Pennsylvania.

We contacted the company, and filed her claim for the 13 months she had home health care. We waited to hear from this company, and we waited, until I called them back to find out (according to SHIP)we needed more documentation. We submitted the "same" documents, including the daily log sheets, which later SHIP said they wouldn't "look" at these papers because it didn't fit their guidelines. The excuses kept coming.

Now it is February 26. Mom had spent $28,000.00 for in home health care and SHIP said they would only pay $175.00. I told 'Helen' (an employee 0f SHIP) I wanted to talk with a supervisor. She only transferred me to another case worker who refused to give me the home office address and phone number.

This company is committing fraud, and sadly during the time people are at their most vulnerable, SHIP fails to meet their obligations.

Sadly, I'm not the only one they have done this to ... BUT it is time for this company to be held accountable for all the people they have robbed over the years.

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