refusal to pay for prescriptions

[pmnorth]

What is the name of your state? MN
I have a health insurance policy that states that I have one year to submit my claims for prescriptions. I was too late in sending these in. The will not pay. Is there any way for me to proceed. I am a single person and I was very sick and unable to handle the forms while I was ill.
Thank you
PMN

 

[tranquility]

All insurance is a contract between you and the insurance company. Government has certain rules regarding insurance contracts, but the core is still an agreement. In this agreement both parties have duties and rights. My understanding from your description is you have the right to be compensated for prescriptions obtained during the coverage period. However, you have the duty, under contract, to submit those claims within one year. You did not do this. Since you did not perform correctly under the contract, the company is not obligated to perform under the contract.

The only thing you could do is ask for a review and hope they make an exception. I don't think they will, but who knows?

 

[rmet4nzkx]

You expect your insurance to pay for prescriptions for narcotics you illegally wrote for your self, Rx fraud, for which you were caught and referred to a professional diversion and then you are going to use your addiction, excuse me "Chemical Dependence" as an excuse to be reimbursed? There is a reason you are facing administrative actions.

 

[cbg]

If you have one year to submit your claims, and you do not submit them within the time frame alloted, the insurance carrier has no legal obligation to pay them. It's as simple as that.