Complaint 4 of 12 in “Errors in Claim Payments”
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- Insurance Carrier: Amalgamated Workers Of North America
- State: PA
March 2007 – I went to the ER of Chilton Memorial Hospital – Insurance from Amalgamated Workers of North America. There is a 90 day Filing Period. Through some clerical errors on the Hospital’s part, the claim was not filed within the 90 days. Amalgamated Ins. company went out of Business in November 2007. The next thing, I received a bill for $10,000 from the Hospital. I need to know if the Dept. of Insurance covers Insolvent Union Welfare Funds? I have an Explanation of Benefits from Amalgamated, as well as a Letter from their Benefit Administrator detailing the fault of the Hospital. Now it is in Collection, and I’m afraid I will be sued.
Insurance Expert Answer:
Go to a lawyer in your state who handles health care law. The lawyer likely can keep the matter from going to collection. I do not know if the insurance guarantee funds in PA cover union plans; in most states they don't. But sometimes in the event of likely insolvency state legislatures add plans that are failing at the last minute.