this concerns my health care insurance. My son goes to an o

by ct2cross » Thu Jun 17, 2010 11:46 pm

sees an out of network physician, because none of the physicians within the plan can provide the care he needs for one condition that he has. There is supposed to be an agreement intact that they would pay at the in network rate due to this, yet they continuously deny the claims and i have to go to extraordinary means to get them paid. Can I sue them?

Total Comments: 3

Posted: Fri Jun 18, 2010 11:08 am Post Subject:

Can I sue them?

I'm sorry...sue who for what?

Posted: Fri Jun 18, 2010 01:12 pm Post Subject: suing for

their consistent refusal to pay claims, and i have to call them again and again and again to get it paid each time there is a claim submitted, even though there is an agreement that they will pay them. This delays needed treatment for my son, example, UV phototherapy unit took over two months to get an approval and this is detrimental to my son's condition because it continues to worsen with severe and uncomfortable symptoms

Posted: Fri Jun 18, 2010 08:58 pm Post Subject:

This delays needed treatment for my son, example, UV phototherapy unit took over two months to get an approval and this is detrimental to my son's condition because it continues to worsen with severe and uncomfortable symptoms

If you can prove this then perhaps, but you'd need to check with an attorney on that, I'm betting if the delay caused him to be uncomfortable as opposed to changing his condition..maybe not enough money for an attorney to want to take it on...

However, being a parent, and bit of a pitbull Mama at that.....What I would (personally) do is to file a complaint with your states dept of ins. Then I'd let the carrier know (be sure you talk to the highest ranking manager you can get) straight up, if there is EVER another delay in my son's treatment due to them. My next call would be to an attorney...period.....and I wouldn't rest until pictures of my boy suffering (due to them) were in every newspaper in the country.

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