If premium payments were made and in fact are still being taken, isn’t the insurer required to make good on past medical bills?

Get Legal Help Today

 Secured with SHA-256 Encryption

If premium payments were made and in fact are still being taken, isn’t the insurer required to make good on past medical bills?

My son was in the US Marine reserve and covered for health by Tricare, which automatically took premiums from his bank. During that time he was unable to get the insurer to pay for medical bills. In fact on several occasions he was told that he was not insured and had to re apply. After several times like this, being enrolled then disenrolled and so on he is no longer in the service but has many med bills that have still not been paid. Tricare says he and his family are not enrolled but continue to take premium payments from his account. His Marine unit told him he was covered for 2 years after.

Asked on February 9, 2013 under Insurance Law, Arizona

Answers:

FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 8 years ago | Contributor

One reason why payments might not be made for your son's medical bills under the insurance policy that you have written about is that the medical treatment might be excluded under the policy of insurance that he has. You are correct that ordinarily if premiums are current then payments for the medical bills need to be made if covered under the policy.

I suggest that the best way to resolve the problem is for your son to call the claims representative under his policy of insurance to see why past medical bills that he has paid premiums for have not been made and follow up with a confirming e mail to such a representative.


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 AttorneyPages.com 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.

Get Legal Help Today

Find the right lawyer for your legal issue.

 Secured with SHA-256 Encryption