California Commissioner Sued by UnitedHealth Over Fine

July 14, 2014

UnitedHealth Group has sued California Insurance Commissioner Dave Jones to block a $173.6 million fine the insurer incurred for violations during a botched acquisition.

The lawsuit was filed last week in Orange County Superior Court, the Los Angeles Times reported. Minnesota-based UnitedHealth said Jones was abusing his power and setting a dangerous precedent by seeking such stiff punishment for relatively minor violations.

State insurance regulators said UnitedHealth, the nation’s largest health insurer, committed more than 900,000 violations after the 2005 takeover of Cypress-based PacifiCare. UnitedHealth has acknowledged the acquisition didn’t go as planned. The company acknowledges numerous mistakes in processing medical claims and customer applications.

In its June 9 decision, the insurance department said its proposed fine “appropriately reflects the gravity of PacifiCare’s offenses and provides the necessary deterrent effect going forward.”

California Insurance Commissioner Dave Jones

California Insurance Commissioner Dave Jones

Byron Tucker, a spokesman for the insurance department, told the Times the agency hadn’t had time to fully review UnitedHealth’s lawsuit.

But he said, “Commissioner Jones carefully applied the law, and the department is confident the penalty will withstand the lawsuit.”

Four years ago, California sought a penalty of nearly $10 billion against the insurer – but that record fine didn’t stand. Last year, an administrative law judge rejected much of the state’s case and said UnitedHealth should be fined no more than $11.5 million.

Last month, Jones rejected that ruling in a 220-page decision and imposed the $173.6-million penalty. He ordered UnitedHealth to pay it by July 22.

Stephen Scheneman, president of UnitedHealth’s PacifiCare unit, said the outsized fine “threatens to paralyze the health care system in the state, resulting in more costs and bureaucracy for Californians.”

Latest Comments

  • July 31, 2014 at 5:13 pm
    Patty Gouthro says:
    Let's not forget the insurers responsibility to their stockholders to make as much profit as possible, even if that means screwing over their clients. Nobody should waste one... read more
  • July 16, 2014 at 12:08 pm
    healthcare says:
    I am sure, underlying this, is Commissioner Jones' belief in a single payer health care system similar to what the VA gets now. If he can put the insurance carriers out of bu... read more
  • July 14, 2014 at 3:20 pm
    bob says:
    $1.736 million is a lot of money. but then when you look at it being for less than $2 for each violation it doesn't seem so high. but it's too much for a single govt bureaucra... read more
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