Nebraska insurer fined for Colorado violations

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World Insurance Company has paid a $153,000 fine for not providing coverage to Colorado customers that it promised, a violation of state insurance law.

The Colorado Division of Insurance cited the Nebraska-based company for:

  • failure to provide coverage for procedures that were preauthorized by the company;
  • failure to provide complete benefits for newborns, including an overly restrictive definition of “complication of pregnancy,” within their policy forms, and a failure to provide appropriate benefits related to therapies for congenital defects and birth abnormalities.
  • inappropriately excluding certain organs, systems and parts of he body from coverage
  • inappropriately excluding certain “high risk” activities such as motorcycling, snowmobiling, off-highway vehicle riding, skiing or snowboarding
  • issues related to the timeliness of claims payment.

World Insurance Company paid the fine to Colorado’s General Fund plus a $7,500 surcharge for the division’s outreach and education program.