Can I sue my medical insurance company?

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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

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 3 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.


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