Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Sep 10, 2010

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Insurance Question from Poplar Bluff, MO

Asked on 09/10/2010

can I cancel Health insurance while I have a claim processing? Celtic health insurance, premium is $400 month for family. I have health insurance through my employer now. Also Celtic is denying this claim in the amount of $15,000 for my son's surgery which they said they would cover in the policy. I had to wait 6 months before the surgery to be eligible for surgery. They said to do a 6 month pre-existing then changed it to a 12 month pre-existing. Please help. thank you

Answer given on September 10, 2010

You’re going to need more help that I can offer to you on this one.  

 

First of all, you’re going to have to prove that there was only a 6-month pre-x clause for your son, at which time you were told he would be fully covered after that, and then show that they changed the pre-x clause to 12 mos from 6 mos.  Who told you 6 mos?  Your carrier?   Your agent?  Your HR person?  I am guessing you had an individual plan for the family and they pre-x’d him out for a waiting period…  is that correct?  

 

As far as cancelling the Celtic plan, yes, you can cancel it at anytime.  It will be cancelled at the end of the month in which you cancel it.  You’ll probably have to submit it in writing; it usually isn’t something you can do over the phone.  As long as you had the insurance for the time frame in which the claim occurred, there shouldn’t be any problems, other than battling with them on the 6 mos/12 mos issue.  Just don’t wait until the last of the month to do it, or it may be too late to get it into their system.  Make sure they send you a certificate of creditable coverage if you haven’t gotten one from them already ( so there are no gaps with your new plan from your employer ).

 

Good luck.  I know it’s frustrating but I would obtain the services of an attorney.  I know a good one in SE Indiana who works on issues very similar to yours for personal injury cases.  


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