Home > Lawsuits > United Health Group, Inc. and United Healthcare Insurance Fraud Class Action
United Health Group, Inc. and United Healthcare
July 30 2007
A class action lawsuit has been filed against the health groups alleging misrepresentation and fraudulent marketing in violation of the Florida Medicare Supplement Act. The Florida statewide civil lawsuit was filed in Pinellas County Civil Court. The suit claims United Health Group, Inc. and United Healthcare of Florida Inc. enrolled Medicare recipients into their Medical Advantage HMO and PPO plans without obtaining signatures or consent to enter into the insurance contract and without informing or advising clients that enrollment into their HMO and PPO Medicare advantage plans disenrolls them from their rightful benefits under the United States Medicare Program.
These enrollees were also not informed that the Medicare Advantage Plans such as Secure Horizons and Complete Care provide limited or no skilled nursing home care, while US Medicare covers 100% of such care for 20 days. The companies also failed to inform clients that the United plans have significant co-payments and significantly more limited availability of physicians who will accept their plan than will accept medicare.
The suit also states that United Healthcare's marketing practices fraudulently imply by names such as CompleteCare and SecureHorizons that the United insurance policies provide equal or complete care when in fact they provide far less care that the Medicare coverage that they replace.
"Last year my mother signed up for the new Part D Medicare programâ"the drug supplementâ"and the insurance company tricked her into signing up for Medicare Advantage (which is privatized Medicare), says lawyer Joseph Saunders. "This case isn't just about the case with her, but the pervasive fraud that goes in the Medicare system and that is why we filed the class action.
Saunders explains that seniors don't realize they are dis-enrolling themselves from Medicare to be in a private HMO PPO and the United Health Care defense is that they are immune from our state consumer laws because they are privatized Medicare and the federal regulations preempt state law.
Saunders filed briefs with the federal court on this preemption issue and United Health Care agreed to pay all of his mother's bills (over $30,000) and make sure she had coverage.
However, Saunders is unlikely to get the class certified. "I expected that the court would rule we were preempted by the federal regulations so we sent the information to Pete Starks of the US Congress--that is where the remedy has to beâ"Congress has to fix this issue," he says. "I don't think a class action is the vehicle that will successfully resolve this issue.
"The case is settled-I believe it was dismissed by the judge yesterday and we are hoping that Congress will address this issueâ"they have been having hearings since last June. We are hoping that Congress will address fraud in the Medicare Advantage programs."
United Health Group, Inc. and United Healthcare Legal Help
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As a frontline costumer service Medicare advocate supervisor for Untied Health for 2 years, I mistakenly thought my primary role was to help customers mitigate these types of concerns on their behalf. On a daily basis, it was my intent to help the callers better understand their polices, billing, rights, and benefits. I was so wrong. After bringing a list of Medicare customer concerns to upper management in September of 2015 my career was over before I could walk back to my cubicle. My actions proved to be a career ending mistake. In less then 1 hour I become the victim of ongoing publically embarrassing witch-hunts. Open attacks with no feasible end in sight. They claim to be the compassion company. United does not practice what it preaches.
Posted by Melissa
I work for united health care as performance manager in kansas city. They have lied to all the hospitals here and given them a bogus incentive to get patients to do preventative exams. They give reports that cant be done . i would love to give more information on them. They treat workers bad and im stuck here do to owing them for paying college loans.
Posted by Florida
Secure Horizons filed an application without my knowledge causing me to loose my coverage with Aetna Medicare. I have been without insurance and RX coverage since
04/01/08. I am a diabetic and on 15 medications a day, I need my coverage back. They need to be punished for what they did.
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