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Complaint 2 of 2 in "Agent Misconduct"

Insurance Carrier: BC/BS
State: Illinois

Consumer Complaint:

Three years ago, the insurance agency handling my small business account failed to advise us that a BC/BS Individual Medicare supplement health coverage for our two employees was available to replace the far more expensive BC/BS Group Plan. Several hundred dollars a month for premiums was paid in excess (for the same coverage) over a period of three years. Our company is seeking recompense of over $22,000. The agency contends it did nothing inappropriate in handing the account.


Insurance Expert Answer:

This is a standard negligence claim against a professional firm for failing to meet a duty it owes you. My bet is the agency will continue to deny responsibility, might argue there were some differences in coverage or benefits between the 2 BC/BS plans, may claim you never asked, and argue that even if they were negligent, you had the last clear chance to avoid financial harm as you each likely received dozens of communications from others quoting lower rates. You might take them to small claims court and seek the highest amount that can be recovered in such court in your state, or if you want more, you'd probably need a lawyer to sue (or threaten) on your behalf. The agency's errors and omissions carrier would likely defend them and assume this is just another one in an onslaught of litigation now being by people hurt by the recession who are trying to recoup money from whatever source they can.


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