Insurers, Reinsurers and Third Party Administrators Claims Fraud
Insurance Companies Have Become Legally Regulated Criminal Enterprises.
FBIC Reports On Insurers, Reinsurers and Third Party Administrators Hidden Relationships ... And Just What They Are Hiding That They Don't Want You To Know About.
Centre Reinsurance is a large reinsurance group affiliated thru common ownership with Centre Life Insurance, and owns 40% of Disability Management Services (DMS). Richard Grilli in his deposition testimony stated that the application filed by DMS to the Ohio Department of Insurance provides false information and conceals the fact that DMS is owned by a reinsurer which is an affiliate of Centre Life Insurance Company. (Documents 1 & 2 below ... these documents are part of an Ohio lawsuit and are public information.)
Document #2 is the deposition of Richard Grilli, the President of Centre Life Insurance Company. Centre Life Insurance is a member of Centre Group of Companies which is supported by an even larger network of common ownership group insurers, reinsurers and third party administrators who are inter-connected through a complicated, incomprehensible, unfathomable and inscrutable 'ownership' maze of U.S. and Bermuda operating, shell and holding companies, ultimately ending at Zurich Financial Services in Switzerland.
The deposition of Richard Grilli, President of Centre Life Insurance Company, provides the roadmap and details the elaborate, smoke and mirror 'reinsurance' schemes, in addition to the total absence of supervision relating to claim denials of a large third party administrator "Disability Management Services, Inc." (DMS) located in Springfield MA. Grilli cites in his deposition that DMS has provided false information in applications documents for many years to the Department of Insurance in Ohio. Most importantly, this deposition acknowledges that the public is being kept "in the dark" about the policies they own and in which they pay premiums.
In the deposition, Richard Grilli states that Centre Life Insurance Company has not found the need to closely oversee and audit their Third Party Administrator, Disability Management Services Inc., because of the lack of complaints filed with state Departments of Insurance (DOI). After taking a closer look, FBIC has found that the reason why there are few or a lack of complaints is because, generally, most all states DOIs neither collect, monitor, track or disseminate consumer claims complaints against 'Third Party Administrators' and/or 'unregulated/unlicensed' Reinsurance companies'. Among other considerations this is a perfect way to circumvent the states DOIs claims complaint monitoring systems.
This deposition highlights individual or private disability policies, but the same exact deceptive scenarios and practices are happening across the insurance industry in other areas of insurance including homeowners policies, auto policies, life policies, business policies, etc. ... FBIC has been receiving similar 'Whistleblower' information illustrating horrible smoke and mirror deceptive practices by a growing number of insurance companies-third party administrators-reinsurance companies working together to avoid paying claims through elaborate schemes while your insurance company shields itself from earning a bad reputation.
FBIC is urging insureds to send a copy of this deposition to all members of their state Senate and House Licensure Committees so they can see that there are major deficiencies and gaping holes within the claims complaint monitoring systems in our state DOI agencies. In addition, it is important to download a copy of your state complaint form if there is a category for complaints relating to disability. (These are private disability policies, not group policies covered by Erisa).
It would be further useful for consumers to see that reinsurance companies, such as Centre Reinsurance, are not listed with your state's Department of Insurance, and The most important questions to ask your State Department of Insurance are:
1) Do they provide a space to complain about Third Party Administrators (TPAs) on their complaint forms?
2) Do they collect complaint statistics on TPAs, who are the people now making the decisions on policy claims coverage?
3) Do they monitor whether licensed insurance companies are properly overseeing their Third Party Administrators or Reinsurance companies they have assigned or given their responsibilities to these entities?
4) Request the application filed by Disability Management Services Inc. (TPA) to see if they have filed accurate information with your state Department of Insurance.
Please send us your results including any forms and most importantly any written replies from your State Department of Insurance. If you need to mail these documents to us, mail them to: FBIC Research, 211 E. Lombard, PMB #112, Baltimore, MD 21202-6102.