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My goals are to retain the insurance coverage ($10k deductible) but I do not agree with having to defer pre-existing conditions that are over 5 years old, that Humana did not ask for on the application. Further, if it is legal for them to do this, do they have the right to defer it for 2 years when their own website says 1 year? How do I fight this?
You have a couple of ways to attack it.
First you can file a complaint with the insurance commissioner in your state. There is information on how to do that at this link.
They can sometimes be helpful but it depends to what extent they are in the pocket of hte insurance companies.
If that doesn't work then the only thing to do is file a lawsuit.
In cases like this they will have to prove that they would not have written the policy if you had revealed whatever they say you didn't.
In addition, it sounds like you revealed exactly what they asked.
It isn't unusual for insurance companies to write policies and then look for ways to get out of them once a claim is made. It doesn't happen as often in health insurance as it does in things like credit life, but it does happen.
If they've done it this time then it is likely a policy for them to do it every time a claim is made within a certain period of time.
So a jury would frown on their behavior.
Exactly. Underwriters are difficult to reach. Is there an another approach I can use directly with Humana to negotiate this? I have a feeling that the underwriter doesn't have the proper expertise to make this decision.
Not one that would be likely to work. Your best bet is to hire an attorney to handle it. Let them contact the insurance company, negotiate, etc. When they are doing this they will be papering the insurance company's file with self serving letters that can be used against them if you have to sue later.
Anything else I can assist with?
That's it- thanks!
Best wishes to you.
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