New Hampshire Fines Anthem $1.5 Million Over Delayed Health Claim Payments

New Hampshire insurance regulators have fined Anthem $1.5 million after an examination found problems with the insurer's handling of health insurance claims and member appeals.

The New Hampshire Insurance Department said the action followed a review of the company's operations and identified instances in which claims were not processed within required time frames. The department also cited concerns involving the handling of appeals from members who challenged coverage decisions.

What regulators found

State regulators said timely claim processing is a core consumer protection. Delays can leave patients, medical providers and families waiting for answers about bills, reimbursements and coverage for care.

The department's findings focused on compliance with New Hampshire insurance requirements. Anthem agreed to the penalty as part of the regulatory action and is expected to address the issues identified by the examination.

Why appeals matter

An appeal gives a health plan member a way to ask an insurer to reconsider a denial or other coverage decision. Regulators said those reviews must be handled promptly, particularly when a decision may affect access to treatment or leave a patient responsible for a significant medical bill.

Consumers who have questions about a health insurance claim or appeal can contact their insurer first and may also seek assistance from the New Hampshire Insurance Department.

Source: New Hampshire Insurance Department regulatory action involving Anthem.