Anthem is Processing and Handling Insurance Claims Offshore: What Does This Mean for You?

If you have health insurance through Anthem, you expect your claims to be processed fairly and promptly. However, recent reports reveal that Anthem has been outsourcing the handling of insurance claims to overseas contractors, raising serious concerns about delays, denials, and the overall quality of claim reviews. If your health insurance claim has been wrongfully denied, this offshore processing may be a key factor in understanding why—and what you can do about it. Learn more below, and contact Gianelli & Morris to review your situation with a team of experienced and successful California insurance bad faith lawyers.

What Is Anthem Doing?

Anthem, one of the largest health insurers in the U.S., has been shifting claim processing operations offshore to countries such as the Philippines and India. This outsourcing includes critical functions such as reviewing claims, making coverage determinations, and even handling appeals.

While Anthem claims this practice helps reduce costs and improve efficiency, it also raises significant issues regarding accountability, accuracy, and compliance with U.S. laws designed to protect policyholders.

How Offshore Claim Processing Affects You

The decision to outsource claim handling can negatively impact policyholders in several ways:

1. Increased Claim Denials

Offshore claim processors may not have the same level of expertise or familiarity with complex U.S. healthcare laws and regulations. As a result, legitimate claims may be denied based on improper or incomplete reviews. Anthem has already faced lawsuits and regulatory scrutiny for denying claims in bad faith—offshoring may only exacerbate the problem.

2. Delays in Processing

Claims reviewed offshore may take longer to process due to communication barriers, time zone differences, and the involvement of multiple intermediaries. This can be especially problematic when policyholders need urgent medical treatments or reimbursements.

3. Privacy and Data Security Risks

Health insurance claims contain sensitive personal and medical information. When this data is processed overseas, it may not be subject to the same privacy protections required under U.S. laws, such as the Health Insurance Portability and Accountability Act (HIPAA). This raises concerns about how securely your information is handled and who has access to it.

4. Difficulty in Appealing Denied Claims

When claims are denied offshore, policyholders often face additional hurdles in getting their denials overturned. Communication barriers, unfamiliarity with U.S. regulations, and a lack of transparency make it harder to navigate the appeals process effectively.

What Can You Do If Your Claim Was Denied?

If you suspect that your health insurance claim was unfairly denied, you have rights and legal options:

• Request a Detailed Explanation – Ask Anthem for a clear and specific reason for the denial. This can help determine whether the decision was made based on an improper review.
• File an Appeal – Insurers must provide an appeals process for denied claims. However, offshore processing can make this more challenging, so it’s essential to be persistent and thorough.
• Consult a Health Insurance Attorney – If Anthem has denied your claim unfairly, you may have grounds for a bad faith insurance lawsuit. An experienced attorney can review your case, advocate on your behalf, and take legal action to ensure you receive the benefits you are entitled to under your policy.

Gianelli & Morris Can Help

At Gianelli & Morris, we have been fighting for California insurance policyholders’ rights for decades. We understand how insurance companies operate—and how they sometimes prioritize profits over the well-being of their policyholders. If your health insurance claim was wrongfully denied by Anthem, our experienced attorneys can help you challenge the decision and seek the benefits you deserve. Contact us today for a free consultation to discuss your case and learn how we can hold Anthem accountable for unfairly denying your claim.