Anthem Health Plans

On October 19, 2003, carpenter John Ellis fell from the roof of a two story house. Ellis suffered a collapsed lung, fractured nine ribs, broke his collarbone and lower four vertebrae and surgeons had to remove a ruptured spleen. He had applied for health insurance on September 2, 2003. The next day, he paid his first premium of $370 which Anthem cashed on September 17th. Ellis filed an insurance claim but Anthem officials told him the "effective date'' of his insurance coverage had not started and he was now ruled ineligible for coverage because of his injuries from the fall. Ellis filed a lawsuit against the company alleging the insurer reneged on coverage to avoid payment. Anthem has agreed to pay Ellis a settlement but both parties agreed to keep the terms of the settlement confidential. (Jun-24-05) [HAMPTON ROADS]

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