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» LymeNet Flash » Questions and Discussion » Medical Questions » lawyers and insurance co. HELP

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Author Topic: lawyers and insurance co. HELP
marblenose
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Member # 6477

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OK Team,
Here's the deal.
I was under my ex's ins. policy. It paid for everything. I started IV tx in early Dec. and the doc's office had to call the ins. every 2 weeks for approval which we got.
Suddenly on Feb. 3 2005 the ins. co. informed me my policy was cancelled on 12/22/2004!!!! I was divorced on Nov. 21,2004 and no one informed me until 1/15/2005.
Now the ins. co. claim I owe all the money about $25,000 all told) because I wasn't insured. The drug store had to put thru for approval for all the oral meds I was taking and they had the same experience...everything was approved until 2/3/2005.
My lawyer is useless and is ignoring me to the point where I wrote the judge to ask for help. I haven't heard anything from him yet either.
I have been uninsured and now can't get a policy until 7/2005. I make just a bit too much for state help.
Any feed back is greatly appreciated.
The stress is overwhelming me.
Blessings,
Marblenose

Posts: 287 | Registered: Nov 2004  |  IP: Logged | Report this post to a Moderator
NP40
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All states have laws that you must be given timely, and advanced notice before any cancellation can occur.

It appears you did not get this.

Secondly, it's also law that you should be given the option to pick up your ex's insurance plan and pay for it on your own, at least for a transisitional period of time.

Call your state Insurance dept. and lay it out for them. Make sure you have the documentation from the pharmacy as well, as well as your own and send copies to the state. You can file the complaint online.

If you didn't receive proper notice, or a chance to continue coverage their looking at disciplinary action from the state.

Tell the insurance company that they can get their Momma' to send them $25 grand, or you'll send it a penny a week by "Pony Express".

Seriously, you won't have to pay.


Posts: 1632 | From Northern Wisconsin | Registered: Jan 2005  |  IP: Logged | Report this post to a Moderator
duramater
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Marblenose:

Much of this is going to depend upon the state laws where you live with regard to notification policies regarding health insurance cancellation.

For example, the Florida statute provides that a health insurance provider must provide the insured written notice at least 45 days prior to cancellation or nonrenewal. Fla.Stat. � 408.909(7) (2002).

The South Carolina Code provides that an insurer must give an insured at least 31 days' written notice of nonrenewal of a health insurance policy. S.C. Code Ann. � 38-71-335.

So, that is going to be a key piece of law for you to find out! Do some searching of google with terms that include your state's name, "health insurance", cancellation, notification. Hopefully your state has such a law.

You might also try contacting your state's department of insurance. Each state has such a dept (with somewhat different names). First, they might know the law for cancellation in your particular state. Second, you can file a claim with them to investigate your situation. It takes up to 6-9 months for them to make a determination, but if it is in your favor, the insurance company has to pay for the services they approved.

I would also check into your COBRA rights (where you could pay for the insurance up to a certain period of time and then are eligible for insurance via HIPAA). Do some searching on these issues as well.

Good luck. I've made use of COBRA rights and department of insurance over the years, and with persistance and using things like the DoI (free!), the insurance company had to pay for the services they approved in every case.

~DM

PS - get a new lawyer!!


Posts: 689 | From western MA (we say buttER and pizzA) | Registered: Nov 2004  |  IP: Logged | Report this post to a Moderator
marblenose
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Thanks team,
I feel bad for the venders who have been so helpful. I hate that I have to hire yet another lawyer to deal with this. I am tired and cranky and overwhelmed with all of this. It's hard enough trying to get better, let alone have to deal with this ca-ca!
Thanks for the feedback and support.
Blessings,
Marblenose

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marblenose
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What is DoI??
Blessings,
Marblenose

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achey
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call your state insurance commitioneer then if that doesn't work, talk to the attorney general"s office.

Sorry it's gotten muddy. It's not like you need this right now.

I hope things clear up quickly and easily


Posts: 663 | From NH USA | Registered: Sep 2004  |  IP: Logged | Report this post to a Moderator
duramater
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DoI=Department of Insurance
Posts: 689 | From western MA (we say buttER and pizzA) | Registered: Nov 2004  |  IP: Logged | Report this post to a Moderator
   

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