Can I sue my medical insurance company?

UPDATED: Oct 1, 2022

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Can I sue my medical insurance company?

On June 14, 2017 I was in a life threatening accident in Europe. I returned home to the U.S, and was informed by my insurance company healthfirst that they would cover me. I received an official authorization number from them and was told not to worry. That was in July 2017. It is now almost a year, and they have not issued payment to the hospital. I have been on the phone with them every week and Im not sure if they will ever pay. The hospital has been sending me collection letters and I just received a 30 day notice/threat of judgment from the hospital. This whole situation has caused a great amount of stress on top of recovering from the initial injury. If my insurance company tries to deny payment, after already authorizing it last year, what are the legal steps that I can take?

Asked on May 26, 2018 under Insurance Law, New York


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 4 years ago | Contributor

If believe that the insurer is violating the terms of your policy by refusing to pay when, under the terms of the policy they should have paid, you could sue the insurer for "breach of contract" for the amount they should have paid. An insurance policy is a contract and is enforceable in court as per its plain terms.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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