Caritas Health Shield Inc. has been ordered to stop selling new health maintenance organization (HMO) plans following several complaints filed before the Insurance Commission (IC).
IC Commissioner Dennis Funa has issued a cease and desist order against Caritas Health, according to a statement.
To protect existing members, Caritas will continue providing services to active accounts.
The IC has been receiving complaints from Caritas clients unable to avail of HMO services as early as 2017.
“The issuance of the Cease and Desist Order was prompted by the numerous complaints received by the Commission on the alleged fraudulent swiping of credit/debit cards and alleged misrepresentations of the company’s sales agents,” the IC said. “According to the explanation of Caritas Health to the Commission, the company had already instituted and implemented various action plans to address said instances of unauthorized swiping of credit or debit cards and misrepresentations.”
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“Unconvinced by the explanation given by Caritas Health and noting that the company acknowledged that there have been instances of unauthorized swiping and misrepresentations committed by its sales agents, Commissioner Funa proceeded with the issuance of the Cease and Desist Order dated July 8, 2019,” it added.
“It should be stressed that the use of credit and/or debit cards as a mode for payment is not the main problem under the circumstances, but the unethical conduct of CHSI’s erring agents/sales associates as well as the apparent lack of timely and effective supervisory intervention by CHSI management.”
“It will be utterly preposterous and a patent disservice to the general public and the HMO industry if this Commission will sit idly by and wait until more complaints are reported before taking action.”
Caritas, established in 1995, prides itself as “one of the most extensive in the HMO industry” with presence in 94 urban centers nationwide. Its website claimed a nationwide network of 15,000 doctors, 343 dentists, 473 hospitals and clinics, 259 laboratories and diagnostic clinics and 21 clinics.
IC declared Caritas “financially stable” in 2017.
