What to do about reimbursements billed to you by your own insurance company years after the fact?

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What to do about reimbursements billed to you by your own insurance company years after the fact?

My old health insurance company has sent me a bill for claims they paid between 3-5 years ago. They claim my insurance was lapsed at the time. My main complaint is that I have no way to show if this was true or not. I also had dual insurance at the time through my wife’s insurance and feel that the opportunity to deny these claims was back then, not 3 years later. I also do not know who to contact to complain.

Asked on April 26, 2011 under Insurance Law, Michigan

Answers:

MD, Member, California Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

You need to immediately contact the agency in your state that regulates health insurance companies; most likely it would be your department of insurance. File a written complaint; explain what occurred and more likely than not the insurance company either made a mistake or someone didn't realize that the statute of limitations may have run and it is now the insurance company's issue. Further, start writing to the insurance company for fighting this issue and make sure you give succinct timelines of this issue and how upset you are these people think it is okay to a) wait a half a decade and b) should have given you the patient summary five years ago.  Further, you relied on their coverage to not file a claim with your other insurance company and a) the insurance company is conducting bad faith coverage and will be reported to the insurance department and federal trade commission and your local news and your federal and state politicians and b) it also caused you to rely to your detriment on its assertions of coverage to you and c) breached its contract with you. Push, push, push is the bottom line with this.


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