INSURANCE CORPORATION FRAUD
by PacifiCare of California (SecureHorizons by UnitedHealthcare) now AARP
Jeanne Spangler suffered a medical emergency called a stroke on November 10, 2007.
PacifiCare or SecureHorizons by UnitedHealthcare did not think a stroke is a medical emergency.
January 26, 2008
Secure Horizons
Attn: Appeals/Grievance Unit
P.O. Box 6106
Cypress, CA 90630
Claim Number 330517401011
To Whom It May Concern:
I am in receipt of your letter dated January 17, 2008 in which Secure Horizons has denied payment due to a faulty interpretation of Jeanne M. Spangler’s medical situation as not being an emergency. I beg to differ with your false interpretation. My mother suffered a stroke on Saturday, November 10, 2007 and passed away on Sunday, November 18, 2007. This was a medical emergency by any definition.
Attached is a copy of my mother’s death certificate. If you want to continue with your false interpretation of a medical emergency, I will take the appropriate and necessary legal steps. I fully recommend that Huntington Beach Hospital be reimbursed for valid emergency medical treatment that was given to my mother on the day of her stroke.
Sincerely,
Lance S. Ferm
Cc: Huntington Beach Hosptial; California Insurance Commissioner
Note: California Insurance Commissioner does not get involved with Medicare disputes.
February 17, 2008
OBAMA FOR AMERICA
P.O. Box 8102
Chicago, IL 60680
Re: Secure Horizons HMO Insurance Fraud
To Whom It May Concern:
Saturday evening I listened with interest to the speech given by Barack Obama to the Democratic Party of Wisconsin. Barack appears to be passionate about issues affecting people by unscrupulous corporations. I am currently being affected by such a company named Secure Horizons HMO Insurance Company.
Here are the facts to the medical situation that led to my mother’s demise and the resulting insurance fraud committed by Secure Horizons HMO.
1) My mother, Jeanne Spangler, suffered a stroke on Saturday morning, November 10, 2007.
2) Emergency 911 was called and paramedics took my mother to Huntington Beach Hospital as it was the closest hospital.
3) The hospital emergency room stabilized my mother’s condition and performed a catscan of my mother’s brain to understand the extent of the bleeding.
4) It was determined that she would need to be transferred to Fountain Valley Regional Hospital that had extensive surgery expertise.
5) Surgeons at Fountain Valley Regional Hospital performed exploratory surgery and determined that the bleeding was too extensive to save my mother.
6) My mother was placed on morpheme and placed in hospice and she passed away on Sunday, November 18, 2007.
7) A notification letter dated January 16, 2008 was mailed by Huntington Beach Hospital explaining that they had not been paid by Secure Horizons HMO.
8) A notification letter dated January 17, 2008 was mailed by Secure Horizons HMO that the invoice from Huntington Beach Hospital was not being paid as the medical help as not an emergency.
9) I responded to Secure Horizons HMO for my 90 year old step-father, Lowell Spangler, with a letter dated January 26, 2008 where I strongly disagreed with their definition of an emergency. Emergency defined: a sudden or unexpected occurrence or combination of occurrences demanding prompt action. Stroke defined: any sudden attack of disease or illness.
10) Secure Horizons HMO has refused to acknowledge any error on their part and their responsibility in making payment despite my mother’s faithful insurance payments via Medicare over numerous years.
11) Secure Horizons HMO has refused to allow my representation in this matter as I do not have the power of attorney.
Barack Obama has my permission to use this information as an example of illegal corporate activities affecting every day Americans that need to be stopped with corporate personnel being held responsible for their actions.
Sincerely,
Lance S. Ferm
Cc: Secure Horizons; HB Hospital; California Insurance Commissioner; LA Times; OC Register
Sandra Sales of PacifiCare of California or SecureHorizons by UnitedHealthcare now AARP made a false statement and refuses to acknowledge any wrong. I refuse to fill out needless corporate paperwork as this is obvious insurance fraud by PacifiCare of California or SecureHorizons by UnitedHealthcare now AARP.
March 8, 2008
Maximus Federal Services
50 Square Drive, Suite 210
Victor, NY 14564
Appeal Number: 1-251752062
To Whom It May Concern:
I am writing on behalf of my deceased mother Jeanne Spangler and her unpaid medical expenses perpetrated by PacifiCare of California (SecureHorizons by UnitedHealthcare). Listed below are the facts with the documentation attached.
1) My mother Jeanne Spangler suffered a stroke on Saturday, November 10, 2007 and passed away on Sunday, November 18, 2007.
2) My mother Jeanne Spangler was initially taken by emergency paramedics to Huntington Beach Hospital where emergency room staff ascertained her condition and then transferred her to Fountain Valley Regional Medical Center on the same day.
3) Fountain Valley Regional Hospital performed exploratory surgery but discovered the bleeding was excessive and family members including myself decided to abide by her medical directive and allow her to pass.
4) We received a notification from Huntington Beach Hospital dated January 16, 2008 stating that their services had not been paid by PacifiCare of California or SecureHorizons by UnitedHealthcare.
5) PacifiCare or SecureHorizons by UnitedHealthcare paid Fountain Valley Regional Medical Center a total of $83.30 out of an original amount of $111,407.75 per a statement received dated January 17, 2008 where my mother’s last week alive were spent and on January 26, 2008, we paid a $200.00 co-payment.
6) PacifiCare or SecureHorizons by UnitedHealthcare sent a notification dated January 17, 2008 to us stating that they were not paying Huntington Beach Hospital due to their definition of an emergency.
7) I responded at my earliest convenience to PacifiCare or SecureHorizons differing with their interpretation of the word emergency on January 26, 2008.
8) I received a letter from SecureHorizons by UnitedHealthcare dated January 31, 2008 in which they wanted me to fill out paperwork for representation purposes. They refused to discuss their faulty interpretation of the word emergency.
9) I promptly contacted the California Insurance Commissioner and received and acknowledgement letter dated February 7, 2008.
10) I began contacting outside sources for help and wrote the Barack Obama campaign with the facts on February 17, 2008 detailing the fraud being perpetrated by PacifiCare or SecureHorizons by UnitedHealthcare that is now AARP.
11) I received a letter from AARP (SecureHorizons) the successor company of PacifiCare where a false statement was made by Sandra Sales the coordinator of the appeals and grievances department. She stated that Huntington Beach Hospital provided services for both Saturday and Sunday, November 10, 2007 and November 11, 2007 respectively. My mother was transferred to Fountain Valley Regional Medical Center the afternoon of Saturday, November 10, 2007. Sandra Sales called me at my place of employment and was uncaring and rude.
12) I have lately discovered that Doctor Andy P. Le, the anesthesiologist has not been paid.
I am simply asking that your judgment be determined upon the fact that a stroke is a medical emergency by any definition. I'm in the process of caring for my 90 year old step-father and I'm afraid that there may be many elderly victims of insurance company fraud who do not have the ability to defend themselves in this country. This would constitute criminal behavior on the part of insurance companies and their employees.
Sincerely,
Lance Stewart Ferm
cc: President of AARP; County of Orange Adult Protective Services; Senator Diane Feinstein; Senator Barbara Boxer