Health Insurer Accuses American National Insurance of Breaching Reinsurance Agreement

GALVESTON, Texas — A health insurer has accused American National Insurance Co. (ANIC) of breaching a reinsurance agreement by denying its claim for reimbursement of a patient’s pre-heart transplant hospital care, arguing that the reinsurer has misrepresented the terms of the parties’ agreement.

In a July 6 complaint filed in the U.S. District Court for the Southern District of Texas, Health First Health Plans Inc. further accuses ANIC of violating the Texas Insurance Code in denying the reinsurance claim.

Health First provided an HMO Plan to a Medicare patient (“Doe Patient”) who visited University of Chicago Medical Center for …