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  1. #1
    pwheatley is offline Junior Member
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    Being sued by hospital for unpaid bill.

    What is the name of your state (only U.S. law)? New Jersey
    I applied for health insurance with my employer after being released from the hospital and they predated the policy to the month before I was admitted.

    When I told my employer that I couldn't afford to pay the full premium they told me the plan was cancelled. I found out 6 months later that they forgot to formally cancel the policy and at that time they offered to pay the premium for me. I immediately tried to file a claim to pay the hospital bill but I was past the 90 day limit to file.

    The bill was over $20k and I was financially unable to afford to pay the bill. My living expenses precluded me from a payment plan that was acceptable to the hospital/their lawyers. Now I am being sued in civil court for $15k, but I am presently unemployed so I figure the lawyer just wants to force me to sell my home to pay this bill. My home is the only property I've ever owned, I'm 50 years old so it would probably be my last, and because of the economy it is worth less than I owe, so selling it would still keep me in debt and make me homeless.

    The insurance company told me in writing, which was forwarded to the hospital/lawyer, that I do not have to pay the bill since technically I was insured at the time of my admittance and technically it is the hospital's obligation to make sure a timely claim is filed. The lawyer says that is a bogus claim but obviously I don't know who to believe.

    Based simply on the insurance company's claim that I don't have to pay, and also that I did pay other hospital bills not related to the hospital stay itself, (each night cost $6000 just for the room), do I have any shot at winning this case? Also, if it looks like I don't have a case, should I file for bankruptcy now or can I wait until after the judgement?What is the name of your state (only U.S. law)?
  2. #2
    JETX is offline Senior Member
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    Quote Originally Posted by pwheatley View Post
    Based simply on the insurance company's claim that I don't have to pay, and also that I did pay other hospital bills not related to the hospital stay itself, (each night cost $6000 just for the room), do I have any shot at winning this case? Also, if it looks like I don't have a case, should I file for bankruptcy now or can I wait until after the judgement?
    Wow... where to start.

    First, the insurance company can't tell you whether you "don't have to pay".

    Second, the obligation is on YOU, insurance or not, to pay the bill. You pay premiums to the insurance company in order to have them pay your bill FOR you. Simply, no insurance, no coverage (payment) by them.

    Third, by your own admission, you didn't have insurance coverage at the time the claim occurred.

    Finally, if your employer likely committed insurance fraud ("my employer after being released from the hospital and they predated the policy to the month before I was admitted.") and you have that in WRITING from them.... your employer could be liable for your hospital bill. You need to see a local attorney on that one.

    The insurance company told me in writing, which was forwarded to the hospital/lawyer, that I do not have to pay the bill since technically I was insured at the time of my admittance and technically it is the hospital's obligation to make sure a timely claim is filed.
    The hospital has NO obligation for timely filing. In fact, that is YOUR obligation. Again, remember, if you HAD insurance at the time of the claim, you would STILL be liable for the bill. Your insurance company, AS A CONVENIENCE to you, would 'intercede' and pay your bill on your behalf. You didn't make sure that YOUR bill was sent to the insurance company in a timely manner.

    BTW, with all the insurance fraud and the unbelievable statements attributed to the insurance company, it certainly sounds like there is FAR more to this story then we are being told.

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