I was sold the wrong insurance plan

[MAcc2007]

What is the name of your state?

I live in Oregon now, but I bought the plan in Utah.

An insurance salesman sold me a plan. My wife and I mentioned we might be interested in having a baby sometime soon so the salesman offered us a supplemental maternity plan that would give us about $5,400 when we had our baby, so we signed up. We waited 30 days to start trying per his advice and we were pregnant soon after.

Four months later I get the policy packet in the mail from the supplemental insurance group and the supplemental only works if the primary insurance covers maternity costs, which our primary insurance does not. So the insurance salesman sold us a supplemental plan that wouldn't cover any baby costs whatsoever.

I have written and signed admission on the salesman's part that he had this in his head wrong because I filed a complaint with the Utah Health Insurance Department and he responded. I have since cancelled the supplemental plan because it wouldn't do anything for us and we applied for Medicaid (per the salesman advice), which we got on fortunately.

My question is in regards to damages in a small claims court. We got on Medicaid which is superior to the supplemental plan we had; however, I want to know if I would be able to get my premiums back (approximately $900 at that point) or something similar. He offered to pay us only $150. I feel he was unjustly enriched by his negligence concerning his policies.

[seniorjudge]

Go to Utah and sue the company and the agent in small claims court. (Chances of getting any dough: About 50-50, more or less.)

Or take the $150 and stay in Oregon. (Chances of getting any dough: 100%.)

Your call.

[MAcc2007]

Originally Posted by seniorjudge

Go to Utah and sue the company and the agent in small claims court. (Chances of getting any dough: About 50-50, more or less.)

Or take the $150 and stay in Oregon. (Chances of getting any dough: 100%.)

Your call.

Thanks for the advice!

What do you believe makes the case 50-50?

[seniorjudge]

Originally Posted by MAcc2007

...

What do you believe makes the case 50-50?

....

That's not what I said.

Re-read my answer.

[MAcc2007]

Why do you believe my chances of getting any dough are 50-50?

[Insurance Pro]

State: Oregon

Keep in mind that there are significant differences in law between the individual states. My suggestion would be to approach the insurance carrier in Utah to see what you might be able to accomplish. Many carriers, especially in the absence of any claims, will refund premium as an "accomodation" to the customer in order to ward off potential litigation and as an act of "good faith" to the consumer. While the insurer does not HAVE to refund your premium, the fact that you have filed complaints with the Utah insurance division and the Utah compliance division has followed up on the case will bolster your request for the premium refund. As far as small claims court, the likelihood is good for recovery. Just remember...you'll have to file the claim and normally attend the hearing. That, in and of itself, could make the $900 premium seem small potatoes.

[ecmst12]

Whether you win in court is totally different from whether you will actually get any money. Enforcing a judgement is a job in itself, if the person does not want to pay you.

I would say that some of the blame still lies with you for not reading the plan in detail BEFORE agreeing to purchase it. One should never rely SOLELY on the word of an insurance agent that a plan is in your best interests; there are a lot of slimy agents out there that will tell you whatever you want to hear in order to get your money. Not ALL of them of course, but anyone who gets paid commission should be treated as biased!