What to do if ahealth insurer told me that I was covered but after I received medical attention, then told me that I wasn’t?

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What to do if ahealth insurer told me that I was covered but after I received medical attention, then told me that I wasn’t?

After finding out I was pregnant, an insurance company informed me (during recorded conversation) that I was covered as a dependent on my father’s plan. After several doctor’s visits and medical test, they then stated that I was not covered due to the fact that I was 26 years of age and they only covered children as dependents until age 25. If I hadn’t been told that I was insured by them in the first place, I would have made other arrangements for coverage. I now have several unpaid medical bills that I believe they should be responsible for paying. What legal action can I take?

Asked on September 30, 2011 under Insurance Law, Missouri

Answers:

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

Answered 10 years ago | Contributor

I would seek consultation from an attorney in your area on the matter and bring with you the policy in question.  o you by any chance have a copy of the tape recording or at least the name of the person you spoke with and the date on which the conversation took place?  You will have to bring what is known as a declaratory judgement action should you have the standing to do so.  That is a lawsuit against your own insurance comany  - of this health insurer - to have you declared a covered person under the policy.  You also might consider calling the state Department of Insurance and filing a complaint.  Good luck.


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