What to do if I was told that I had medical insurance but didn’t?

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What to do if I was told that I had medical insurance but didn’t?

After being laid off of work I required medical attention. My medical insurance accepted all charges from doctors, specialists and pharmacy because according to my previous employer, HR department, my medical insurance was still good and active for the following four months. Now it turns out that my insurance company is denying coverage. Can the insurance company demand that all the doctors and specialist return the money and charge me for services provided?

Asked on February 7, 2013 under Insurance Law, Texas

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 8 years ago | Contributor

If it turns out that you fact were not covered for some valid reason--such as separation from employment--your insurer may indeed disclaim coverage and force you to pay for the medical service yourself; an insurer is only required to pay pursuant to the terms of a validly in-force policy. However, if you were denied the chance to get coverage--such as through COBRA--due to some error or omission of your former employer, you may have a legal claim against the employer for the medical costs you have incurred.


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