Healthcare provider called a scam by regulators; patients left in deep debt

A healthcare provider is being called a "scam" by the Washington State Insurance Commissioner. The state has ordered Aliera HealthCare to " immediately stop selling health insurance illegally in Washington state and engaging in deceptive business practices" in May, and ordered the company to pay a $1.1 million fine in August.

The company promotes itself as a "health care sharing ministry."

Customers in Washington say they've been left with mountains of bills they can't pay.

“I'm extremely frustrated, it's a waste of my life,” said Sandi Kamuf, who lives in West Seattle and is fighting with Aliera HealthCare to get the company to pay out claims. “This week alone I've already spent three days on it,” she said.

Her husband got in a biking accident in February and broke his wrist, dislocated his shoulder, and bruised some ribs. The bill they got for his trip to the ER cost more than $7,000 dollars.

Kamuf said Aliera didn't pay a cent.

“You can see right there there's zero pay,” she said, pointing to a document sent to her from Aliera.

She said according to her plan, a visit is supposed to cost $300 but the company told her the closest hospital they went to – Harborview Medical Center – is out of network.

“I'm really angry. Really angry,” Kamuf said.

There’s another case of a man diagnosed with throat cancer who said the company is refusing to cover any of his treatment, forcing him to max out credit cards to get chemotherapy.

Another woman in Seattle said the company wouldn't cover her hip replacement.

A friend started a GoFundMe that raised just enough money for her to get a new hip in Mexico.

There are dozens of cases like these across the Puget Sound and the Washington State Insurance Commissioner, Mike Kreidler, is working to put a stop to it.

“What we saw and what we're aware of at this time, it's clearly a scam,” Kreidler said.

The commissioner said the company claims it's not an insurance company but instead, a healthcare sharing ministry –  something that isn't regulated by the state.

“Even though they're selling a product that looks, and walks and in every aspect, looks like insurance, they’re claiming it's not insurance. They're trying to find a loophole,” Kreidler said.

Through a public disclosure request KIRO7 got ahold of the training video where the speaker calls their service “health insurance” before quickly correcting himself.

“We’re finally applying health insurance - healthcare - in a market that…” you hear the speaker say.

When people started filing complaints to the Washington State Insurance Commissioner, the state launched an investigation.

“We got in there and we put a cease and desist  on them,” Kreidler said.

So the company can't recruit any new customers in Washington but it already has  more than 3,000 customers in this state and about 100,000 customers nationwide.

Many of them are face mounting medical bills, their claims ignored.

“We’re getting ready to go to collections if we don't pay soon,” Kamuf said.

“Deny, deny, deny,” Kamuf said. “And they hope you’ll go away,” she said.

“It’s so dirty, and they call themselves faith-based. I don't know any faith that would treat people that way,” Kamuf said.

The insurance commissioner said he’s looking into whether there is enough wrongdoing to recommend criminal charges.

“Is it possible here for criminal activity? I don’t know yet,” Kriedler said. “If it’s a prosecutable case, we’re going to make sure it’s done,” he said.

Cox Media Group