What is the best legal option against an insurance company that forged both mine and my spouse’s signatures to authorize coverage and payments?

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What is the best legal option against an insurance company that forged both mine and my spouse’s signatures to authorize coverage and payments?

About a year ago, I was investigating getting health insurance coverage from a company. They rejected my spouse, but accepted me. I told them I didn’t want the coverage because we wanted the both of us to be covered the same company. Subsequently, an agent at the health insurance company forged both mine and my spouse’s signature and began to bill us for coverage. I have since contacted the insurance company who directed me to their appeals department to put a stoppage in and seek reimbursement. I was wondering whether this would affect my statutory rights and whether another course is better?

Asked on July 22, 2011 Texas

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 9 years ago | Contributor

If they forged your signature, they have committed both a crime--actually, possibly several crimes; e.g. identity theft; some form of theft, such as fraud--and also a civil tort, or grounds for you to sue them for both damages (e.g. to recovery any expenses or losses you've suffered) and to get an order from the court directing them to correct what they did. They have also almost certainly violated various insurance regulations. You should consult with an attorney who can advise you of the best course(s) of action and also help you take action--it is probably the case that you should, at a mimimum, seek some compensation from the insurer for this act and report the incident to the state agency regulating insurance; however, let your attorney guide you. You don't have to just go through the internal appeals process of the company which did you wrong.


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