My mother has been with her insurance company for years and years. She recently was in the process of undergoing knee surgery. Two weeks away from surgery date her insurance gets cancelled. Apparently, she forgot to send her September payment in. She sent August and October. Since she forgot September they cancelled her and gladly refunded her October payment. She was stunned that she had somehow forgotten a payment. They would not work with her and it looks now as if they went ahead and cashed her October payment, knowing they didn't get a payment for the previous month. Can she win this fight and continue her insurance coverage, or should she write it off and be more cautious?
2006-10-17 04:55:57 · 19 answers · asked by jj 1 in Health ➔ Women's Health
if they cashed the October and have not returned it...they should continue the coverage. call the insurance commissioner and see what your next move should be. the insurance company's hate when you call the commissioner on them, but in this case it should be done!!!! call an attorney and get some advise also, they will give a free consultation too.
good luck, and i know what the knee surgeries are like, i wish her much and quick results!
2006-10-17 05:56:04 · answer #1 · answered by Anonymous · 0⤊ 0⤋
You can go to the insurance board... They should have sent a notice of cancellation via certified mail. From the day the cancellation was processed, you then have 10 days until your insurance will actually go out of effect (I process cancellations and reinstatements for an insurance company)... well, this is the way it is in CA anyway... If your mom sent in an October payment, someone should have called and brought it to her attention. Also, if they went ahead and charged her because they didn't receive a payment, then she is COVERED for September!
You might want to let us know what state you are in since there are different laws... Might get better help that way.
I'm a rookie, so if anyone has any corrections to what I wrote, please advise...
2006-10-17 05:26:38 · answer #2 · answered by Nicky G 2 · 0⤊ 0⤋
i would fight because she has been with the company so long
The only thing about switching insurance companies is some policies have a preexisting clause that will not cover certain thing for up to the first year or so of the policy
why wouldn't the insurance company not post the payment for October for September and then call her to tell her that she was missing a payment
Insurance companies don't want to have to pay claims anyway so this is there way of getting out of paying for her procedure
2006-10-17 05:25:54 · answer #3 · answered by jenniferevans32 3 · 0⤊ 0⤋
Try to fight it...you never know until try...My guess is thought you probably will not win on your own... when the insurance company did not receive the Sept. pymt they probably had already began the cancellation process. and once they received the October pymt they probably then reviewed your mother's file for reinstatement, however being that she was getting ready to have sx I can see how/why they have decided to stand by the cancellation...I know this sucks....
Good luck!!
2006-10-17 05:33:26 · answer #4 · answered by Anonymous · 0⤊ 0⤋
In the USA, such things are usually addressed at the State insurance commissioner's office.
The terms of the insurance contract will dictate much of what happens.
Her insurance agent might be able to help her as well.
2006-10-17 05:04:24 · answer #5 · answered by geek49203 6 · 2⤊ 0⤋
Call the insurance company, and talk with the president. THey need to give you so many days, before they cancel the policy.
2006-10-17 05:36:22 · answer #6 · answered by Pauly W 7 · 0⤊ 0⤋
Fight it! They HAVE TO send out several notices before they can cancell insurance. Looks to me as they didn't send the notices because they didn't want to cover/pay for her surgery! FIGHT IT!
2006-10-17 05:25:57 · answer #7 · answered by Nerds Rule! 6 · 0⤊ 0⤋
If she needs the surgery she should try to fight it; if she goes with another insurance company they may not cover it due to it being a pre-existing condition. Unless she qualifies for medicaid in which case they cover almost everything.
2006-10-17 05:05:35 · answer #8 · answered by seriously shannon 3 · 1⤊ 0⤋
she should fight it cause they had Octobers payment therefore they had a payment. What a bunch of crapola this one is. Since they cashed Octobers payment she should have coverage now.
2006-10-17 05:13:33 · answer #9 · answered by elaeblue 7 · 0⤊ 0⤋
quick make whatever payments are needed to bring it up to date. dont cash any refund checks you get. Call state insurance board. Fight Fight Fight!!!!!
2006-10-17 05:47:37 · answer #10 · answered by Anonymous · 0⤊ 0⤋