My husband was about to sign up for disability and hospital stay insurance but the insurance guy gave us the run around. All my husband had to do was sign the paperwork. The insurance guy told him he was going to write everything up and that he was going to stop by in the next couple of days. Well, we left several messages on his phone and even told him that some of the other co-workers would like to sign up too. He never called back or came by. One of the co-workers gave him a call and was told also that he would have the papers ready in a couple of days and that he would stop by. Well, my husband suffered a heart attack in the meantime. We contacted the insurance company directly to find out about any chances of them covering any of the cost. They denied since they didn't receive the application. However, turns out that the insurance agent is in big trouble now and they sent someone else out to take care of the applications. Do we have a chance suing them?
2007-01-21 12:31:01 · 12 answers · asked by Nat 2 in Politics & Government ➔ Law & Ethics
Not sure if it's ok to say the name????
But it starts with an A
2007-01-21 12:43:03 · update #1
Yes, we do have proof for all the phone calls and we're not talking about some outrageous amount of money. Just help with the hospital bill.
2007-01-21 12:48:33 · update #2
I think you have a chance of getting some kind of compensation...if you approach it right. Remove that American part of your brain that automatically runs to litigation, and focus on the insurance company. In reality, the insurance company doesn't have any obligation to honour the intention of coverage...only coverage itself. But the insurance company may feel the need to make up for the incompetence of the agent. The two things you need to ascertain are:
1. If the agent was a broker, or working directly for the insurance carrier - if a direct agent...you stand the best chance. If a broker, you may want to approach the brokerage firm.
2. Do you have any proof or record of your transactions with the agent - you may stand a chance if you can prove his incompetence.
You must also realize that your husband's heart attack may appear indicative of a pre-existing condition. If proven, the insurance would probably have been null and void anyway.
Good Luck.
2007-01-21 12:41:56 · answer #1 · answered by Super Ruper 6 · 0⤊ 0⤋
If you gave a binder payment with the application you will definately win. A binder is the first months premium or more. If your application didnt go through underwriting yet, it wasnt approved and therefore not finalized, or made a binding contract. Also read the fine print, depending on the type of policy, you may be assumed coverage through the application process.
2007-01-21 12:36:38 · answer #2 · answered by Zach L 1 · 0⤊ 0⤋
Unfortunately, the insurance company is not liable as you have not signed up with them.
You do not have coverage until you sign on the dotted line....
..sorry you had such bad luck, but he may have been turned down for insurance anyway if he had any pre-existing condition...
...secondly most companies have a 30 waiting period anyway!
...oooch!
2007-01-21 12:36:52 · answer #3 · answered by Rada S 5 · 0⤊ 0⤋
you need to seek legal counsel. if there is evidence that things were in place and were about to be finalized then i think you should have a good case. Afterall the employer in this case is responsible for the employee. However if you have no evidence that this is the case, then it is your word against someone elses. In such a case the best lawyers will win, and trust me the insurance company will have far greater resources then you. Sorry to say.
good luck and i'm sorry for your unfortunate circumstances
2007-01-21 12:36:30 · answer #4 · answered by shaker 2 · 0⤊ 1⤋
You can always sue!! I could sue you now for your question. The real question is, do you have a chance to win?? People can sue for whatever they want, whether or not it gets tossed out by a judge is another issue. I hope that it works out well with you and yours.
2007-01-21 12:45:30 · answer #5 · answered by Jerrysberries 4 · 0⤊ 0⤋
Definitely, your insurance company was very incompetent in getting your application filed, sue them and switch, btw who is your provider, I do not want them protecting me
2007-01-21 12:36:10 · answer #6 · answered by Eric D 3 · 0⤊ 1⤋
yes, I'm not a fan of suing, but in this case yes. Actually they will probably be willing to settle with you. Get a lawyer.
2007-01-21 12:35:05 · answer #7 · answered by The Scorpion 6 · 0⤊ 1⤋
If it was a preexisting condition it may not have been covered anyway. I would see a lawyer and ask his opinion.
2007-01-21 12:35:48 · answer #8 · answered by Barkley Hound 7 · 0⤊ 0⤋
yeah it sounds like it... Tell the company first about the problem, if you get no where then talk to a lawyer... Ususally the lawyer can right the company a letter and they will pay.
2007-01-21 12:35:19 · answer #9 · answered by sooners83 4 · 0⤊ 1⤋
Insurance is not liable if you didnt have a contract with them.
2007-01-21 12:41:26 · answer #10 · answered by Mom 5 · 0⤊ 0⤋