Delaware’s Department of Insurance has announced penalties totaling over $350,000 against Highmark for improper volunteer ambulance company claims reimbursements. Insurance Commissioner Trinidad Navarro revealed that Highmark had been sending payments to patients for ambulance services instead of directly to the ambulance companies, as required by law. This resulted in a lack of funding for volunteer ambulances, as patients were unlikely to forward the money to the companies. Navarro expressed concern over the impact this had on those living paycheck to paycheck.
The Department has instructed Highmark to take corrective actions and stated that the hefty fine was due to the high volume of violations by the insurance company. Navarro mentioned that the fine would go to the state’s General Fund rather than the volunteer ambulance companies, but he hoped to change this in the future. The investigation also found instances of Highmark refusing to pay claims without conducting a proper investigation, particularly in cases where patients required emergency care but were initially seen at a physician’s office.
Navarro emphasized the importance of insurance companies following the law and ensuring that payments are made to the appropriate parties. The penalties imposed highlight the seriousness of the violations and serve as a warning to other insurance providers. The Department of Insurance will continue to monitor compliance to protect the interests of both patients and healthcare providers in Delaware.
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