driver67373
Member
What is the name of your state (only U.S. law)? Arkansas
I had an inpatient surgery in March 2014. I had primary insurance (through my employer) and a secondary policy through my university, which was a full major health insurance plan (AIG trough First Health Network). Primary paid, no issue there. The secondary has not paid. Initially, they denied stating I needed to file with worker's compensation insurance. The claim was worker's comp several years ago, but was closed. I sought further treatment more recently under my own insurance. Once I showed them that documentation, they changed their denial to a different reason.
The coverage began effective January 1, 2014. As previously stated, surgery was March 2014. Their current denial reason is that the policy has a pre-existing condition clause that does not cover conditions that were treated within 6 months of the policy effective date. It is my understanding that beginning 2014 the Affordable Healthcare Act banned denails for pre-existing conditions. So is what they are doing legal? Is there some part of the Act that allows this? Thanks.
I had an inpatient surgery in March 2014. I had primary insurance (through my employer) and a secondary policy through my university, which was a full major health insurance plan (AIG trough First Health Network). Primary paid, no issue there. The secondary has not paid. Initially, they denied stating I needed to file with worker's compensation insurance. The claim was worker's comp several years ago, but was closed. I sought further treatment more recently under my own insurance. Once I showed them that documentation, they changed their denial to a different reason.
The coverage began effective January 1, 2014. As previously stated, surgery was March 2014. Their current denial reason is that the policy has a pre-existing condition clause that does not cover conditions that were treated within 6 months of the policy effective date. It is my understanding that beginning 2014 the Affordable Healthcare Act banned denails for pre-existing conditions. So is what they are doing legal? Is there some part of the Act that allows this? Thanks.