Articles Posted in Health Insurance

Last week the Maryland Insurance Administration revealed that six new insurers have been licensed to do business in Maryland this year, and that 11 previously licensed insurers have been approved to sell additional insurance products. This is very good news not only for Maryland’s insurance industry, but for Marylanders as well.

The arrival of new insurers should inject competitive energy into our state’s insurance market and provide consumers with a greater range of options. The approved applicants include life and health insurers, as well as companies licensed to provide workers’ compensation, mortgage guaranty, and surety insurance.

The competitiveness of state insurance markets has been questioned for years, especially with respect to health insurance. Supporters of the Affordable Care Act hoped the law would increase competition, but now the industry is looking to consolidate further (see proposed merger between Anthem and Cigna). In light of these developments, today’s announcement comes as welcome news indeed. The more companies competing for business, the better.

The Affordable Care Act (“Obamacare”) has placed health insurers under substantial financial pressure. This pressure appears to be resulting in an increasing number of healthcare claim denials.

Unfortunately, the increase, if it exists, cannot be documented with hard data; historical data on the number of healthcare claim denials issued by private insurers doesn’t exist. The ACA now requires qualified health plans to report data on denials, but participating insurers only began doing so in 2015.

Anecdotal evidence, however, clearly points to an increase.

As a former Senior Counsel to the Maryland Insurance Administration, and now a private practice attorney concentrating in insurance law, I am receiving more and more calls from people facing financial crises caused by health insurers’ denials of large medical claims.  I have represented a number of clients who had large health insurance claims denied, only to see the insurer reverse the denial once I was hired to fight back.  Continue Reading