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Old 01-20-2004, 09:19 PM
mbaker3
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Angry

insurance company caused my credit to be ruined


I am in Kentucky. I visited the emergency room. My insurance company refused to pay the claim. I appealed and was denied. The hospital turned me over to collections. Collections reported me to credit bureaus. I kept appealing. In third appeal I threatened to sue under ERISA (my employer funds the program, but CHA Health administers it, so state law is not pertinent, federal law covers this type of deal).

Insurance company then admitted fault and overturned decision. They paid the claim. Meanwhile, my formerly perfect 20-year record of credit was ruined. I want insurance company to repair my credit.

I am trying to apply pressure through my employer and the state's attorney general office (though, this may not do much since they are set-up to side-step state laws). I have invested hundreds of hours in this case and if they don't act fast I will want to receive damages in addition to repaired credit.

I am growing impatient with them. They were always wrong (as they have admitted), I was always right - yet my credit is ruined. I may need to buy a house soon. How do I make them do the right thing ?

Thanks to anyone with ideas.
  #2  
Old 01-21-2004, 08:07 AM
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Join Date: May 2003
Location: NJ
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How old is this bill?
  #3  
Old 01-21-2004, 09:54 AM
mbaker3
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The emergency room visit was 23 Feb. 2003, but the bill has been paid - after CHA Health realized I would not just roll over for them (I had to get crappy and forceful in my 3rd appeal - to CHA, which I found curious).

I enlisted the help of the hospital administration to refute their assertions that my treatment was not an emergency (because the triage form was marked non-urgent - hospital wrote letter explaining that triage form does not impact on ultimate nature of visit, just indicates that they can see someone who is losing blood prior to seeing me) and their other objection was that I had not called the nurse helpline (equally ridiculous).

I used a few choice terms, like "the differential diagnosis of abdominal pain is too extensive to be handled by phone" suggested by the head of the Emergency Department at the hospital and "my actions were those of a prudent lay person" suggested by the US Dept. of Labor - since CHA has sidestepped the KY laws by just "administering" the program funded by my employer. I made it clear in my 3rd appeal that I would eventually be heard by an impartial arbiter of fact, once their "appeal" process was exhausted as I do have the right to sue them under ERISA (Fed. law)

The problem is that their actions (which they have now admitted were wrong by overturning their denial of the claim and by paying the claim) have caused my formerly perfect credit to be disparaged

I know worse things have been perpetrated on many others, but I will not be wronged by these people without a fight. If we all avail ourselves to legal remedies when we are wronged, these companies may eventually learn that it is more cost-effective to do things right than it is to cheat the poor.

Thanks to any and all who read my story and special thanks to anyone with ideas to help me get the arrogant perpetrators to repair my credit rating. I may need it soon.

Take care all and Fight Back !!!
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