Complaint 6 of 16 in “Claim Denied / Delayed in Whole or Part”

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  • Insurance Carrier: Unicare
  • State: KY

Consumer Complaint:

I was told several times from my health insurance company that they would cover a surgery provided that I met certain criteria. I have met every single criteria and they have denied it. I have appealed and my surgeon has appealed but both times it has been denied.

Insurance Expert Answer:

What is the basis for the denial? Your answer to that claimed denial? Who is your employer? It matters -- the status of the employer under ERISA may be critical. Watch the time limits on appeals VERY carefully.

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