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Coalition Against Insurance Fraud

Fake health plan steals more than $150M from consumers

February 11, 2019, Chicago, IL — Patients buried in medical bills when they thought they were covered by comprehensive medical insurance; they bought policies that promised a lot, but covered almost nothing.

Julia Wilber was one the victims; a home care worker whose troubles began when she fell and sprained her leg while getting on the bus.

“I couldn’t walk after that,” she said.


She went to a hospital emergency room, confident she was covered by health insurance she bought online through a broker called Simple Health Plans, which claims to offer affordable and dependable coverage.

Wilber paid $183 a month – more than $3,000 over 17 months – before she discovered her coverage was practically worthless. The hospital sent her a bill for nearly $7,000.

“Simple Health is only paying $50 of it,” she said.

She’s not alone. The Federal Trade Commission has sued Simple Health Plans and five other companies for allegedly engaging in deceptive sales tactics to convince consumers they were getting comprehensive health insurance.

“It was not comprehensive health insurance, and unfortunately consumers didn’t realize that until they had a need to use the insurance,” said FTC Midwest region director Todd Kossow.

“That is pretty shocking,” Wilber said.

The FTC said thousands of consumers lost more than $150 million combined on the scheme.

“It’s one of the biggest I’ve seen, and it’s one of the most egregious I’ve seen,” Kossow said.

The FTC said the scheme allowed Simple Health Plans founder and CEO Steve Dofrman to live lavishly. Expenditures included a $300,000 wedding, and an engagement ring valued at $600,000.

Meantime, consumers like Wilber were left with stacks of unpaid medical bills they can’t afford.

“I would say there is about $15,000 to $20,000 in here of my responsibility,” Wilber said.

Dorfman has denied the allegations, but a federal judge has temporarily frozen his assets and shut down his companies.

Eventually, the FTC hopes to get money back for thousands of victims of the alleged scam; many of whom might not even realize they don’t really have comprehensive health insurance coverage.

If you think you might have purchased one of these policies, you should contact the court-appointed receiver in this case at 833-300-6257.

Source: CBS Chicago

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