News: 2007 Press Release

SACRAMENTO - Insurance Commissioner Steve Poizner today announced a settlement with United Healthcare over alleged violations of California law involving claims payment practices. This multi-state settlement involves 37 states working together to protect consumers.

"This settlement exemplifies the tremendous success we can achieve for Californians by working together with other states," said Commissioner Poizner. "Protecting California consumers is my top priority, and I will continue to take steps to ensure that their health care claims are paid correctly."

Allegations of claims mishandling and other administrative practices were reviewed through a series of state-led market conduct examinations. United Healthcare has agreed to pay a fine of up to $20 million nationally in restitution for systemic errors which led to these concerns and allegations.

California residents make up 1.3% of the total policy holders affected by this agreement. As a result of the settlement, United Healthcare will pay $260,293.80 to California's General Fund. Most United Healthcare policies in California are written through the company's affiliate, PacifiCare Health and Life Insurance Company. PacifiCare is not included in this agreement because most of its claims handling processes are not yet integrated with the platforms which led to the allegations against United. California's Department of Insurance continues to exercise full independent jurisdiction over Pacificare Health and Life Insurance Company. Consumer complaints are not affected by this agreement and California consumers are encouraged to contact the Department of Insurance at 1-800-927-HELP with complaints or requests for help with any California health insurance company.

United Healthcare has agreed to implement a detailed three-year process improvement plan to achieve annual benchmarks established in this agreement. The California Department of Insurance, in conjunction with other lead states and a third party review firm, will monitor the company's compliance with the process improvement plan and ensure that United Healthcare is attempting to meet the annual benchmarks. In the event United Healthcare fails to meet the yearly process improvement benchmarks, an additional $20 million in national fines could be levied against the company.

Copy of United Healthcare settlement.