Formal complaint filed with the West Virginia Court of Claims
January 18, 2008
1. West Virginia Insurance Commissioner Examiner Dena Wildman illegally sent my private papers to Carelink, compromising my case.
2. Wildman made a final judgement, siding with Carelink in the Grievance process, without thorough investigation of the rider that was key to dismissal of grievance and which a Carelink employee told me NEVER existed. Wildman was aware of this inconsistency.
3. State statute was ignored...grievance process took too long. Filed complaint on September 29, 2005. Ruling made January 2006. State law requires speedy decision, made more urgent by my surgeon Dr. Bernard Costello’s request for rapid decision.
4. At two different times my individual requests for two different hearings were “stuck” in system. They were not discovered until I called attention to the problem. In one case it was weeks later.
5. State statute was ignored. It took too long to process one claim; to this date I have never received a formal reply to the second one.
6. Appeal to the West Virginia Court of Appeals paperwork was lost for five months. Head of the legal department Mary Jane Pickens admitted the error.
7. The Commission does not publicize final orders. Final Order 06-AP-024 dated December 14, 2006, establishes a precedent for HMOs to reasonably research requests for procedures. WV citizens must learn that this rule exists for justice to be served them and the health care received for which we pay dearly. The internet is full of factual stories of HMOs denying first and asking questions later. Sadly, too few doctors and consumers have the time or are educated to fight for these rights. I have been in contact with an official in the Governor’s office regarding this very questionable lack of following through with process to insure consumers receive health care to which they are entitled.
8. The Commission has refused to enforce the very order it signed. This order was signed by Ms. Cline on December 14, 2006 and will radically change the way HMOs do business in our state,. Since 2006 the lace of enforcement has potentially compromised the health of hundreds and hundreds of citizens, who likely had requests unfairly rejected as I.
9. Carelink and the West Virginia Insurance Commission reached an agreement behind closed doors and Carelink withdraw their appeal regarding this issue. See January 2, 2008 Defense Response, page 4.
10. The Commission stopped my challenge of discrimination by Patrick Dowd, former CEO of Carelink, from begin brought up at my administrative hearing on August 10, 2006. This greatly compromised my hearing. Additionally, an allegation was subsequently made in a document associated with the civil lawsuit Christine Stenger vs. Carelink Health Plans, Inc. and Patrick Dowd which suggested that I was not concerned enough about the discrimination to bring it up at my hearing. This false allegation was made to the federal court of Judge Frederick Stamp.
See page four of the Defenants' Response to Plaintiff's Motion to Remand:
NAIC Website
Final Order of the Office of West Virginia Insurance Commissioner 12 6 05
http://www.freewebs.com/courageoffaith/2006%2012%2014%20Final%20Order.pdf
Letter to the President of the National Association of Insurance
October 13, 2008
Sandy Praeger, NAIC President Commissioner Kansas Department of Insurance
NAIC Executive Headquarters
2301 McGee Street, Suite 800
Kansas City MO 64108-2662
Dear Ms. Praeger:
I am contacting you as an advocate for the mentally ill and a committee member of the Catholic Diocese of Wheeling Charleston Council for Disabilities in West Virginia. I believe that there is much corruption in the Office of the West Virginia Insurance Commissioner. This corruption contributes to the grave health care crisis in one of the poorest of states.
In the past if anyone would have told me about the widespread corruption in the West Virginia Insurance Commission, I would have told them that they were misinformed. Unfortunately, I, and others, will testify to the grave injustices.
Much of my story is told at www.tuesdaytiradesandtales.blogspot.com. I believe that there is more than enough evidence to indict Jane Cline, Commissioner of the West Virginia Insurance Commission and President elect of NAIC.
While there may not have been a high level of scrutiny about this internal corruption and collusion with my HMO, Carelink Health Plans, Inc. of West Virginia, Americans are now more closely watching regulatory agencies. With the very difficult economic times we are experiencing, we are being made aware of the depth of scandals within corporations and government.
And we are angry.
My accusations are very serious, Ms. Praeger, and I must assert that there be a thorough investigation of Ms. Cline without delay. I personally shudder to think of the hypocrisy were Ms. Cline to represent the high principles of NAIC as President in 2009.
Thank you for your attention to this very serious matter. I look forward to your reply and a just resolution to this problem.
Sincerely,
Christine O’Brien Stenger
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