I went to the chiropractor and the doctor filed a claim to my insurance company. They denied my claim, saying my injury had built up over a long period of time, therefore making it a pre-existing condition. I didn't think this was legal in California, considering that I got the insurance through work. I'm looking into it, and considering getting a lawyer. Should I bother?
2006-07-13 15:10:04 · 6 answers · asked by Irate Consumer 2 in Health ➔ General Health Care ➔ Other - General Health Care
You have already gotten some good advice about checking your plan, checking with Human Resources, asking the insurance company. You should do all those things. If you get to the end of your rope and you have not received a satisfactory resolution, don't call an attorney yet - they are expensive and you have one more no-cost option. Contact your state insurance department and lodge a formal complaint against the insurer. They carry a lot of weight with insurance companies and may be able to provide good help to you. In California, go to http://www.insurance.ca.gov/contact-us/0200-file-complaint/index.cfm
Best wishes.
2006-07-14 03:35:19 · answer #1 · answered by Anonymous · 1⤊ 0⤋
Yes - you can be denied coverage for a pre-existing condition. Sometimes the condition will be covered after you have been insured with that particular company for a year. The best thing to do is contact your Human Resources department and ask them to help you review what your insurance covers. They usually give you a book that explains everything - but sometimes those books are pretty vague. A lot of insurance companies do NOT cover chiropractic care of any kind - so be sure to check that out.
Chiropractor treatments are usually not that expensive - especially when you consider the cost of hiring a lawyer.
2006-07-13 15:41:01 · answer #2 · answered by petlover 5 · 0⤊ 0⤋
I personally dont know about CA law because I am from MI but most insurance companies can deny claims for pre-existing conditions. And most claim alot of things to be pre-existing. Look in the handbook that you got from your employer first, then contact the insurance company themselves. Ask them to explain why they classified this claim as a pre-existing condition. Then if the answer is not satisfactory or it seems that they just do not want to pay the claim, contact an attorney.
2006-07-13 15:28:13 · answer #3 · answered by spikeslady 2 · 0⤊ 0⤋
Insurance companies can deny your claim due to a pre-existing condition BUT if you were insured prior to the coverage you have now and they covered your condition then the insurance you have now has to cover you. At least that's the way it was with my insurance and mine is like a MAJOR medical condition.
2006-07-13 15:40:20 · answer #4 · answered by Nurse S 1 · 0⤊ 0⤋
For any type of insurance you can be denied coverage because of a pre-existing condition. You can contest what is pre-existing or not though. All the best to you!
2006-07-13 15:17:21 · answer #5 · answered by Anonymous · 0⤊ 0⤋
It sucks but Insurance companies can do ANYTHING. lol
They can Deny you for almost any reason. THO most will just let you have coverage not including Things that where preexisting for like 6 months.
2006-07-13 15:13:47 · answer #6 · answered by Andrew P 3 · 0⤊ 0⤋