Fortis Insurance Company, Quest Health Plans ripoff, consumer fraud, outright thief Greenwood Village Colorado

I am a Regulator for a State Insurance Department with 20 years experience, and the situation you describe is one I have had to deal with many times. Hopefully, this will give you some options to consider, and also act as a guide to others so the same thing does not happen to them.

First: The agent should have made every attempt to assist in securing your COBRA conversion, if it was applicable. Under Federal Regulation, it is the "employer's" responsibility to offer the conversion within within 14 days, or no more than 30 days of the qualifying event. Call the Employee Benefits Security Administration, which is a division of the United States Department of Labor, on their toll free number 1-866-444-3272 (CST), and ask for their most recent copy of the COBRA phamplet. It describes in detail your rights, and the employer's obligations under the law.

Second: In the absence of a COBRA conversion, where an employer employ's less than 20 people on a full time basis, our State Legislature has required our High Risk Pool to implement a "Portibality Plan" to put us in compliance with the Federal Regulations under HIPAA (Health Insurance Portability & Accountability Act) that President Clinton signed into law a few years back. It is quaranteed issue, quaranteed renewable, no riders, no rate ups, and no pre-existing condition limitations, to age 65, or Medicare eligibility, which ever comes first. If COBRA were not an option, and this type of program has been adopted by your State, then the agent should have directed you to that plan. To find out if your state has something similar, contact your State Department of Insurance. To find yours go to "http://naic.org/state_web_map.htm", it lists all fify state insurance departments.

Third: Under our State Law, the company is responsible for the actions of its appointed agents/producers. The Principal/Agent relationship clearly states that, the knowledge of the agent, is the knowledge of the company. Based on your complaint, it appears the agent had little regard for your needs, and was more concerned with making a commission. You may want to check with your State Insurance Department to see if they have a similar statute.

Forth: The agents actions ultimately resulted in sever detrimental financial consequences for you, and you have every right to demand the agent file a claim against his E & O carrier, to recover your loss. If he refuses to do so, again, contact your state insurance department.

There were any number of ways to avoid this situation, but it certainly appears that the agent was not knowledgable enough to pursue the appropriate course of action on your behalf .

Lastly: You need to file a complaint with your state insurance department against Fortis as well as the agent. If the condition for which you received treatment was not pre-existing, and you were completely candid answering the health questions on the application, they have no grounds upon which to deny your claim, and would probably be a violation of your states Unfair Practices Law. The only way to know for sure, is to let your state insurance department investigate.

I hope you find this information helpful.

(since this does not have a "spell check" option, all errors are my responsibility)

Andy was overly impatient. Fortis Insurance mailed him his refund within the 60 day period required by law. He threatened us numerous times that he would "ruin us" by making these bad reports. He reported us to the BBB and Colorado Insurance Commissioner, both of which dismissed his claim as frivolous and vindictive.

The sad part of the story is that as good a service as Ripoff Report provides, every time you look up our company name on the internet, you see the heading Consumer Fraud etc etc.

When a Company is in the right, and the complainer in the wrong, the complaint should be removed from the internet, so that people like Andy can't "use" you to harm innocent companies who have done no wrong.