What can I do if my dental insuance company has refused to pay for a routine dental cleaning?

My 2 children and I had a routine cleaning 9 months ago and our insurance paid for my daughter and I but not for my son. Our dentist resubmitted the claim the next month and noticed it still wasn’t paid 5 months later. When they contacted my insurer, they were told that they would no longer process claims for my husband’s employer because they discontinued service and changed insurance companies 2 months after the cleaning was performed. Is there anything we can do? I don’t understand how an insurer can do this. Our premiums were all paid. I’ve made several calls and they are now telling me they ran out of funds for my husband’s employer.

Asked on August 31, 2014 under Insurance Law, Michigan

Answers:

M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney

Answered 6 years ago | Contributor

Contact your State Department of Insurance in your state and file a complaint against the company.  See what happens.  If the insurance was paid up by you then you had coverage and the claim should not have been denied. Especially since they paid two of the three.  Good luck.


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