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Kentucky Office of Insurance Clarifies That Failure To Disclose Medical Information Is Fraud
06 May, 2008 WorkersCompensation.com
Bowling Green man faces felony charge after allegedly lying about his health
Frankfort, KY (CompNewsNetwork) - The Kentucky Office of Insurance has issued some
information on Disclosure of Medical Information for insurance purposes.
“Lying or leaving out relevant information on an insurance
application is fraud,” said John Burkholder, acting executive director of the Kentucky
Office of Insurance (KOI). “Often, consumers think those things are minor and don’t matter.
That thinking is very wrong.”
The KOI Fraud Investigation
Division receives many referrals regarding instances where a consumer has supplied false,
misleading or incomplete information on a health insurance
application.
Tracy Cardwell, 40, of Bowling Green, recently was
indicted on a felony count of insurance fraud after he allegedly completed an Anthem Blue
Cross Blue Shield application for individual health insurance, indicating he had no
significant health problems. After Anthem accepted Cardwell in the plan, medical records
showed he had health conditions that were not disclosed on the application. The company
rescinded the policy and received refunds from the providers who had treated Cardwell. He
now is responsible for repaying the more than $14,000 paid for his medical care under the
Anthem policy.
“Consumers often think that leaving out
information can result in a lower premium or will ensure acceptance into a plan. This case
underscores the need to be totally truthful on an application. Otherwise, you could pay a
lot more in the end,” said Burkholder.
KOI is an agency of the
Department of Public Protection in the Environmental and Public Protection
Cabinet.
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