South Bend Employers Sue Company Over Unpaid Health Claims

SOUTH BEND, Ind.–Some of the South Bend area’s largest employers have filed lawsuits against a company hired to process health insurance claims for their employees.

The employers allege that they paid millions to Healthcare Resources Group, but the company never sent that cash along to health care providers. As a result, some providers have come after patients for their money, several of the plaintiffs argue in court documents.

A message seeking comment was left Wednesday by The Associated Press at the office of Terry A. Grant, president and chief executive officer for HRG. He declined to comment to the South Bend Triune on Tuesday.

The employers–including AM General, St. Joseph County’s government, the city government of South Bend, Memorial Health Systems, Quality Dining and 1st Source Bank –are self-insured, meaning they finance payment of their own claims, but they contract their processing out to a third-party administrator.

AM General’s lawsuit claims it paid the firm more than $3 million for worker claims that have yet to be paid. An HRG employee last week told Gary Wuslich, the automaker’s vice president of human resources, that the funds were “missing,” Wuslich stated in an affidavit filed with AM General’s lawsuit.

The city of South Bend filed a lawsuit Tuesday alleging that $971,000 it paid HRG for employee health care claims from March 29 to May 4 have not been sent to care providers. St. Joseph County’s lawsuit, also filed Tuesday, says it is missing more than $625,000 it paid HRG. Memorial Health Systems has filed suit to recover more than $252,000.

Most of the employers say they have terminated their contracts with HRG and are searching for new administrators. The Indiana secretary of state’s office April 14 ordered the company “administratively dissolved,” meaning state law prohibits it from conducting any business except “that needed to wind up any business and liquidate affairs,” office spokesman Joseph Feeney-Ruiz said.

The action resulted from HRG’s failure to file its biennial “entity report,” a form that simply lists a company’s address and officers.

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