• Insurance Carrier: Assurant
  • State: MO

Consumer Complaint:

I had maternity rider and because the birth was coded other than normal birth the insurance will not pay the bill.

Insurance Expert Answer:

With the limited information provided, we can't make suggestions so if you want a response, please explain the issues in a bit more detail. For starters, was the insurance involved obtained through a private employer, or a governmental employer, or was it purchased directly from an insurance company? (Why is this important? - There are different laws that apply if the policy is subject to ERISA, a Federal law impacting certain employee benefit plans.) Second, how long before the onset of the pregnancy did your insurance coverage begin? Third, what reason did the insurance company give for denying benefits? Fourth, what about the explanation you got from the insurance company do you think was wrong? Fifth, if you think it is miscoding have you spoken to your doctor or the hospital to get the coding corrected and sent that in to the company and given them enough time to reprocess the claim?