Insurance Co. Problem
buddyb
Member Posts: 5,366 ✭✭✭✭
Last September the wife went to the doctor,that sent her to the cardiologist and he determined she need by pass surgery. She never ate anything bad and walked or rode a bicycle almost every day.The last person you would think had heart issues.We have pretty good insurance and after the surgery she was fine.I had taken out supplemental policy to pay what the primary did not cover.Primary was Blue Cross and they were very good and paid as agreed.The supplemental has not paid anything and keeps putting us off and making excuses.We contacted the state insurance commision and they were told that they were not paying because it was a pre-existing condition.That is incorrect because she has never had any cardiac issues.It appears the next step is to hire an attorney.I need advice on what type attorney handles these sort of things.
Comments
Check medical records and find out if there are any predetermined conditions. If not, ask insurance co where they got the information.
As you navigate this, be sure you have followed through the appeals process contained in your policy….to the letter. Often, you must appeal in writing. If you do not follow the process, sometimes you can be prevented from filling a suit.
I'd contact most any nearby lawyer, if they don't handle such they will definitely point you to one with the expertise in insurance claims. Most will not charge you for recommendations to others.
"Never do wrong to make a friend----or to keep one".....Robert E. Lee
I was under the assumption that insurance could no longer deny payment because of a pre existing condition. Am I wrong?
I think that varies state to state, but I could be wrong.
I think that's true under Obama Care but not all of the others…..and I could be wrong about that too.
"Never do wrong to make a friend----or to keep one".....Robert E. Lee
Do an internet search for reviews on the supplemental policy and company. There are likely people out there that have encountered the same issue as you have.
Do everything in writing by the deadline dates and keep USPS tracking information on it.
Signature required on any mailed correspondence.
Yea, I separated my wrist a couple of years back and went to the ER take a guess? They wouldn't touch me without an EIN # or Home Owners LLP. It's Black Friday "OUI" just steal it! Molina Healthcare IEHP… ! Civil Rights.
My dental insurance hasn't paid my DDS for something like 6 months for molar extraction? The DDS people said my insurance said they were backed up for 3 months or something. Typically they were pretty good about paying but I don't know why now.