Health Insurance Nightmare

[CactusFlower]

What is the name of your state? Michigan

Hubby is self-employed and we have no health insurance. A few years ago some one suggested that we contact a company to obtain health insurance for self-employed persons (not sure if I can legally mention the company name, so I won't for now).
We contacted this company and met with an agent.....we paid the monthly premium (over $500.00) on May 31.....on June 4, hubby was hospitalized with a severe (nearly fatal) allergic reaction to penicillin. He remained in the hospital for 6 days. The agent that we had met with somehow got wind of the hospitalization and informed the insurance company, as a result they made our new policy effective as of June 5 (the day after hubby was admitted), and thus refused to pay for any of the cost incurred while hubby was hospitalized. We kept paying the premiums for this company for approximatley 6 months, and everytime we had to see a physician, the only thing we ever got from them were notices for things that they would not pay. And believe me there were many follow up visits after this incident, it has been 5 years and hubby is still having residual effects from this allergic reaction.

I am posting this as a warning to those of you that are self employed.........Check all companies out throughly before you commit, don't get screwed like we did. I found several warnings similar to this one on the internet, after the fact, sure wish I had had the forethought to check them out before we got screwed!!

If someone could let me know if it would be legal to name the company, I would love to put there name up in lights, but don't need a law suit as a result.

 

[driftbuster]

if you are self employed check out our chamber of commerce. They usually have good rates for insurance. Health insurance is very confusing and sometiems the great deal is no deal at all.

 

[Jeter]

Unless you have a pending or active law suit against the company, it isn't illegal to mention the company name. All it would be is bad publicity for them. Your insurance policy should have been in effect from the 1st day of June. That's a scam.

Jeter

 

[CactusFlower]

I Agree Jeter

It Sure Is A SCAM!!

Just wish I would have checked it out before I gave them any money.

 

[cbg]

CactusFlower, file a complaint with the Better Business Bureau and the State Insurance Commission. You might be able to get your money back.

 

[CactusFlower]

Even Though it has been 5 years??



This all happened about 5 years ago. Would it still be beneficial to file a complaint? I wanted to do this when it all occured, but had no idea who to contact to file a complaint.

How do I contact the State Insurance Commission??

 

[cbg]

If it happened five years ago it may well be past the statute of limitations. But you can ask. I don't have the number for the state insurance commission in Michigan - I'm in Massachusetts. But try your phone book in the state listings.

 

[CIAA]

The legality of this type of occurance is dependent on the "receipt" that you are given when you give the agent the first premium payment and are the terms of this receipt are regulated to some extent.

It is typically called a "conditionl receipt" because it has some conditions that must be met. For example, it will usually be conditional on approving the applicant's health application and should specify a time limit for the company to do this and will specify what the effective date will be. Some conditional receipts specify that the applicant must be in good health with no health changes "when the policy is delivered".

In any event, the terms of the "conditional receipt" will rule, so it should be read carefully and understood by everyone that applies for an insurance policy.