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Can I sue my insurance company in small claims court?

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sjhalani

Junior Member
What is the name of your state (only U.S. law)? California

What is the name of your state (only U.S. law)? California

I purchase my own insurance through Covered California (Obamacare). I received a termination letter from my insurance company in July back dated to April 30, 2015. They kept sending me multiple letters for 3 months prior to that stating that I owe $112.52 and I have 90 days as a grace period to make my payment, but I made a payment of $112.00 (I was 52 cents short for a few months) every month from April to June, so it leaves no chance of the 90 day grace period running out. Also, I paid them $97.55 per month (my 2014 yearly premium) in Jan and Feb 2015 because I was unaware that my premium was going to increase from $97.55 to $112.52 for 2015. I only found out about the increase in monthly premium in March of 2015, after which I began paying $112.00 every month.

All the letters that I would receive from the billing department of my insurance company would tell me that I was $112.52 overdue, which was much higher than the amount that actually I back owed to them (which totaled to $31.76). I found this out today on the phone with their representative. Had they given me an accurate figure in their billing statements for the amount back owed, there would be no such problems. My mistake was due to ambiguity on their billing end. Even though I have proof that they've cashed all my checks until June 23, they're still not reinstating my policy. They insist that I wait till November, the next open enrollment period for California. Covered CA is not helping me; I've made complaints to Department of Managed Healthcare and Department of Insurance, but I'm not sure how much power they have to enforce a decision.

I wanted to know if there is any way that I can take this to the small claims court. If so, would I have to file in a small claims court close to me or close to the insurance company's office? I appreciate any help. Thanks so much!
 


Proserpina

Senior Member
What is the name of your state (only U.S. law)? California

What is the name of your state (only U.S. law)? California

I purchase my own insurance through Covered California (Obamacare). I received a termination letter from my insurance company in July back dated to April 30, 2015. They kept sending me multiple letters for 3 months prior to that stating that I owe $112.52 and I have 90 days as a grace period to make my payment, but I made a payment of $112.00 (I was 52 cents short for a few months) every month from April to June, so it leaves no chance of the 90 day grace period running out. Also, I paid them $97.55 per month (my 2014 yearly premium) in Jan and Feb 2015 because I was unaware that my premium was going to increase from $97.55 to $112.52 for 2015. I only found out about the increase in monthly premium in March of 2015, after which I began paying $112.00 every month.

All the letters that I would receive from the billing department of my insurance company would tell me that I was $112.52 overdue, which was much higher than the amount that actually I back owed to them (which totaled to $31.76). I found this out today on the phone with their representative. Had they given me an accurate figure in their billing statements for the amount back owed, there would be no such problems. My mistake was due to ambiguity on their billing end. Even though I have proof that they've cashed all my checks until June 23, they're still not reinstating my policy. They insist that I wait till November, the next open enrollment period for California. Covered CA is not helping me; I've made complaints to Department of Managed Healthcare and Department of Insurance, but I'm not sure how much power they have to enforce a decision.

I wanted to know if there is any way that I can take this to the small claims court. If so, would I have to file in a small claims court close to me or close to the insurance company's office? I appreciate any help. Thanks so much!

What is it you wish to accomplish?
 

sjhalani

Junior Member
re

I want to get my coverage reinstated, that's all. Don't want to pay for not having insurance since there's a fee for that too. I'd rather pay and have insurance.
 

Proserpina

Senior Member
I want to get my coverage reinstated, that's all. Don't want to pay for not having insurance since there's a fee for that too. I'd rather pay and have insurance.
Small claims can't do that for you, sorry.

But stand by (it'll be tomorrow most likely), because I'm going to message our Benefits guru to see if she can help some.
 
Small claims can't do that for you, sorry.

But stand by (it'll be tomorrow most likely), because I'm going to message our Benefits guru to see if she can help some.
Is our Benefits guru by chance named Helen wait? I've heard of her I tell people to go to Helen wait and she will fix you right up.
 
Last edited:

cbg

I'm a Northern Girl
I'm not familiar with Covered California, so I'm going to need to ask you a few questions.

How is it that you were not aware of a premium increase? Do you receive monthly statements? Is there an online website where you can check your account?

Why were you shorting the change when you made the payments?

If you were to make the payments, would the coverage reinstatement be retroactive?
 

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