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  #1  
Old 04-29-2009, 01:24 PM
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Join Date: Apr 2009
Posts: 1

health care claim denial


What is the name of your state (only U.S. law)?
Kansas
My husband got health insurance for us both via his new job with Oregon trail equipment . The insurance was provided my Meritain . He started work 2nd feb 09 and was told he would have to wait 1 month foR health insurance to begin . We subsequently received 2 cards from Meritain with an effective date of 04/03/2009.
On 26th March I was admitted to hospital with pneumonia and Meritain are saying the cards have the wrong date on them . They should have read 04/01/2009 and have subsequently refused to pay the claim.
The company handbook ( which they had run out of so we did not receive) apparently states that health insurance cannot be applied for until 1 month after the start date and only takes effect 1 month later .
I am very angry as we have ended up with a bill of almost $5000 . Had I been aware that the claim would not be paid , quite frankly I would have returned to England for $500 and been treated for free ( I am a British National here on a spousal visa)
Do I have any recourse?
  #2  
Old 04-29-2009, 01:58 PM
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Join Date: Mar 2006
Posts: 6,673
Why are you using different dating notations for effective coverage and date of service?

U.S. is month/day/year. I'm not seeing the problem. Even if we didn't have a date issue, I don't see a cause of action against anyone. Certainly not the provider, nor the insurance company. Perhaps the company if they were required to provide the coverage booklet at hiring and someone told you something different.
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  #3  
Old 04-29-2009, 02:00 PM
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Join Date: Jan 2005
Posts: 21,351
Quote:
Originally Posted by chrissy51 View Post
What is the name of your state (only U.S. law)?
Kansas
My husband got health insurance for us both via his new job with Oregon trail equipment . The insurance was provided my Meritain . He started work 2nd feb 09 and was told he would have to wait 1 month foR health insurance to begin . We subsequently received 2 cards from Meritain with an effective date of 04/03/2009.
On 26th March I was admitted to hospital with pneumonia and Meritain are saying the cards have the wrong date on them . They should have read 04/01/2009 and have subsequently refused to pay the claim.
The company handbook ( which they had run out of so we did not receive) apparently states that health insurance cannot be applied for until 1 month after the start date and only takes effect 1 month later .
I am very angry as we have ended up with a bill of almost $5000 . Had I been aware that the claim would not be paid , quite frankly I would have returned to England for $500 and been treated for free ( I am a British National here on a spousal visa)
Do I have any recourse?
Just so you're clear. 04/03/2009 is April 3rd, 2009.
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