Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, July 12, 1995 TAG: 9507140003
SECTION: BUSINESS PAGE: C-7 EDITION: METRO
SOURCE:
DATELINE: RICHMOND LENGTH: Short
Trigon reported to the state Bureau of Insurance back interest on claims amounted to $1,503,000, instead of the $412,000 it had put into escrow last April as part of a settlement. Trigon also paid a $538,000 fine in April.
The interest was owed to hospitals and other health care providers for claims that took Trigon more than 15 days to pay.
The settlement was unrelated to an agreement last year by Trigon to pay a $5 million fine and refund millions of dollars of excess co-payments.
Trigon spokeswoman Brooke Taylor said a companywide review found it owed interest on 56,339 claims by health care providers.
She said Trigon had checked a sampling of claims to come up with its original $412,000 estimate.
State regulators discovered the unpaid interest during a review of Trigon's operations from July 1, 1990, to June 30, 1992.
The review also found Trigon may have misled customers in some of its advertising and may have violated state requirements on setting claims within state-set deadlines and on notifying policyholders when it denied claims.
The state regulators said those claims-handling problems, along with not paying interest owed on claims, ``occurred with such frequency as to indicate a general business practice'' that violated the state's unfair claims settlement practices law.
Trigon now automatically pays interest after 15 days.
- Associated Press
by CNB