Ask a Lawyer and Get Answers to Your Legal Questions
Hello, and thank you for contacting Just Answer. I am an expert here and I look forward to assisting you today.
Unfortunately, no, there wouldn't be any recourse against the hospital.
First, if you review the documents you or your wife signed at the hospital then you will see that you agreed to be responsible regardless of what the insurance company does. In addition, the language will also state that the hospital may file on the insurance on your behalf but it is doing so as a courtesy.
Second, and this is mingled with the first point there is the fact that you have contractually agreed to pay for the services.
Third, there is the equitable concept of quantum meruit, which essentially means that a person deserves to be paid for services performed.
You would be much more likely to succeed if you pursued the insurance company for failing to pay pursuant to the terms of their contract with you.
The website is showing you are offline so I will exit so I can assist other customers. Please feel free to ask any follow up questions that you have in this thread. However, please do not issue a rating until our interaction is complete and all of your questions have been answered.
Re this: You would be much more likely to succeed if you pursued the insurance company for failing to pay pursuant to the terms of their contract with you.
It looks like the chat function may be having problems so I'm going to change this to a Q and A format.
What's the best way to go after my medical insurer - they've declined me once for lack of authorization (which I trusted my doctor to obtain) and then they declined me again saying it wasn't necessary - even after my doctor vehemently disagreed and wrote out a long explanation that Cigna's appeals people rejected. Per Cigna, they told me I could go to the State Appeal board - which I've been told usually sides w/ big insurance. So is that (State appeal) my best and only move?