The Carmel-based insurance company said today that the settlement affects customers of two subsidiaries: Conseco Senior Health Insurance Co. and Bankers Life and Casualty Co. Regulators in Pennsylvania, Illinois, Texas and Florida also took part in the investigation.
Conseco will follow an agreed-upon plan to speed processing of claims and complaints, a plan that was part of an improvement program the company undertook in 2007. Conseco is investing $26 million over the 2-1/2 years to improve computer systems and business processes. It also is moving several back-office personnel to a third-party, Long-Term Care Group Inc.
Under the agreement, Conseco will pay a fine of up to $2.3 million. It could face an additional fine of $10 million if it fails to adequately improve its marketing and customer-handling practices.
Conseco will review certain claims from 2005, 2006 and 2007 and provide up to $4 million of payments to customers.
"Conseco encouraged and fully supported this exam, especially in light of industry policymakers' focus on senior marketplace issues relating to long-term care and spiraling healthcare costs," Conseco CEO Jim Prieur said in a written statement. "As we expected, after an extensive review the examiners did not find that Conseco had engaged in a practice of improper claims denials."