medical claims information needed..

Submitted by Anonymous (not verified) on Fri, 10/05/2007 - 09:00

my insurer is reluctant to renew my policy. I'd like to know if this can be avoided & also want to know the duration within which a company needs to pay for medical claims. I've recently undergone an open-heart surgery & the charges were worth $20,000. The carrier has agreed to pay me $11,000. So, I'd also love to know more how to fetch more out of them, since the amount agreed is certainly not justified. Looking forward to you guys for a solution to my queries, Patty Thornton

Posted: 05 Oct 2007 09:18 Post Subject: lemme try!

Hi Patty
why don't you tell us whether your policy is renewable guaranteed or not! Well, lemme just explain that in case your policy is not renewable then your carrier has all the right to stop renewing your policy. Thats the reason why i'd ask you to got through the policy papers carefully & understand the clauses that speak about cancellation & the circumstances that speak more abt it or at least in some way or the other relate to it.
Thanks, Collin

Posted: 05 Oct 2007 10:46 Post Subject: time to pay!

Hey buddy! sometimes some more information are invited to support whenever a claim is requested. But a carrier would get around 45 days to process and pay towards a claim once the loss gets proven Thats it!
Casandra Van Huesen

Posted: 05 Oct 2007 11:25 Post Subject: rates..

Well, its truly painful to know that even after suffering with your health you now have to trudge through all these complications. At the same time I'd also like to tell you that the rates irrespective of whether realistic or routine would differ amongst the providers & health care units.

If there is a complicated surgery performed by any physician, then he can stress upon the critical areas & state his worth. Likewise, the policyholder may also appeal after analyzing the routine rates of different physicians of that particular area or by demanding an explanation of rates from the carrier itself. Styleman00

Posted: 05 Oct 2007 11:48 Post Subject:


Welcome to!

If you could tell us what state you reside in, we could get more specific.

Just about every state has laws and rules that govern health, more accurately, medical expense coverage. In fact, most states have rules that will not allow a carrier to simply cancel or nonrenew medical coverage. In order to get you this info, please let us know where you live.

Additionally, in many states there are laws that require that a claim be paid within a specific time frame. Knowing your state will also give us the ability to research a little for you and get you some proper information.

As far as what the insurer paid on your claim, there are a myriad of reasons as to why only $11,000 was paid on a claim in excess of $20,000. We have no idea of what kind of plan you have, the dollar values of things like your deductible, coinsurance arrangement, stop-loss arrangement, etc. These are all crucial elements of a medical contract.

So, if you can provide additional can we! Thanks, and let us know what we can do to help you out!

InsTeacher 8)

Posted: 06 Oct 2007 05:28 Post Subject:

Welcome to the community guys.

Welcome to!

InsTeacher you made a mistake with the TLD. :)


Posted: 08 Oct 2007 04:28 Post Subject:

Evan (and all of you),

SORRY!!! Just moved, had a grandchild, transitioning jobs at's my official correction:

Welcome to ampminsure.ORG.

Is that better? lol

InsTeacher 8)

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