How can I take legal action to get what is owed by my insurance company?

UPDATED: Dec 10, 2012

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How can I take legal action to get what is owed by my insurance company?

I have an AFLAC Group family plan through my work. I have had this plan for almost 2 years. Then last month, my wife who is covered on this plan had our first child prematurely and the baby had to be admitted to the hospital for 3 days. I filed the paperwork to add our newborn to the policy within the 30 day time limit, but AFLAC is saying that the newborn coverage doesn’t begin until the next billing month. How can they do this?

Asked on December 10, 2012 under Insurance Law, Florida


B.H.F., Member, Texas State Bar / FreeAdvice Contributing Attorney

Answered 9 years ago | Contributor

You can file a complaint with your state's department of insurance.  They usually handle most claims when insurance companies are refusing to pay on valid claims.  Before filing a suit, it's better to start with an administrative complaint because many disputes can be resolved throught this process without the necessity (time and expense) of filing your own suit.  Here is a link to the complaint section for Florida as a starting point:

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