How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Joseph Your Own Question

Joseph
Joseph, Lawyer
Category: Legal
Satisfied Customers: 5276
Experience:  Attorney with significant and substantial experience in multiple areas of law.
54899578
Type Your Legal Question Here...
Joseph is online now
A new question is answered every 9 seconds

HOW SUCCESSFUL ARE SUITS AGAINST ASSURANT HEALTH (TIME INSURANCE

Resolved Question:

HOW SUCCESSFUL ARE SUITS AGAINST ASSURANT HEALTH (TIME INSURANCE OF MILWAUKEE, WI) FOR REFUSAL TO PAY MEDICAL CLAIMS/BILLS IN ILLINOIS SMALL CLAIMS COURT?
Submitted: 1 year ago.
Category: Legal
Expert:  Joseph replied 1 year ago.
Hello and welcome to JustAnswer

I'm sorry to hear about your situation and hope I can help.

My name is XXXXX XXXXX my goal is to provide you with excellent service today.

I need a bit more information from you before I can proceed to provide you with a complete and thorough answer to your question.

It depends on what the basis of the suit would be. What was the coverage that was denied and for what reason?

Have you tried appealing the denial through the insurance company yet?
Expert:  Joseph replied 1 year ago.
Also, could you please write without all caps. It is a lot easier to read when you type without capslock on. Plus, it reads as if you are shouting when you use all caps.

Thanks.
Customer: replied 1 year ago.

Thanks. Basis of suit: failure of insurance company to pay my Illinois chiropractor's billings for services rendered to me in Illinois. They claim a "Licensed chiropractor" reviewed copies of his records and determined that none of the care was "medically necessary". However, they refuse to provide my provider with a copy of this alleged "Licensed chiropractor's" written report to refute/answer. Assurant Health claims that under Wisconsin Insurance Law they do not have to provide that information.


 


Coverage denied was for chiropractic care covered under this policy.


 


As a side note, they paid a similar claim a year or two ago.


 


Assurant Health in their denial material provides a process by which to appeal. However, in the past I have found this to be similar to a "kangaroo court". Besides, services were rendered in Illinois by an Illinois provider. Since Time/Assurant is licensed to do business in Illinois, one would think that this matter would be properly subject to Illinois Insurance Law-- not Wisconsin.


 


Thank you Joseph.

Expert:  Joseph replied 1 year ago.
Hello Brad,

Unfortunately, you are typically required to exhaust all administrative remedies at your disposal prior to filing suit, so you should definitely try to go through their process although it definitely appears to be a kangaroo court.

You would have a claim against the company for bad faith for failing to pay on the claim that is covered under your policy. You are also definitely correct that the policy should be interpreted under Illinois law, and Wisconsin, since the insurance company is located in Illinois and the service that you received was in Illinois.

With that information and a determination that the medical coverage was necessary (as it seems to have been a continuation of care you received in the past that was approved) you should be successful in your claim against Assurant Health.



I hope the above information is helpful.

Please let me know if you have any clarifying questions as I want to ensure that you are completely satisfied with my service. Definitely contact me if you are contemplating leaving me a negative rating, as I’ll be happy to continue to address your concerns until you are satisfied with my service.

If not, please remember to rate my answer positively so I get paid for my work. It is necessary for you to rate my answer even though you’ve made a deposit or are a subscriber. I only receive compensation for my work if you rate me positively. Otherwise, I receive nothing for assisting you, and the website retains your entire deposit.

Thanks and best of luck!

-Joseph
Joseph, Lawyer
Category: Legal
Satisfied Customers: 5276
Experience: Attorney with significant and substantial experience in multiple areas of law.
Joseph and 6 other Legal Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • Mr. Kaplun clearly had an exceptional understanding of the issue and was able to explain it concisely. I would recommend JustAnswer to anyone. Great service that lives up to its promises! Gary B. Edmond, OK
< Last | Next >
  • Mr. Kaplun clearly had an exceptional understanding of the issue and was able to explain it concisely. I would recommend JustAnswer to anyone. Great service that lives up to its promises! Gary B. Edmond, OK
  • My Expert was fast and seemed to have the answer to my taser question at the tips of her fingers. Communication was excellent. I left feeling confident in her answer. Eric Redwood City, CA
  • I am very pleased with JustAnswer as a place to go for divorce or criminal law knowledge and insight. Michael Wichita, KS
  • PaulMJD helped me with questions I had regarding an urgent legal matter. His answers were excellent. Three H. Houston, TX
  • Anne was extremely helpful. Her information put me in the right direction for action that kept me legal, possible saving me a ton of money in the future. Thank you again, Anne!! Elaine Atlanta, GA
  • It worked great. I had the facts and I presented them to my ex-landlord and she folded and returned my deposit. The 50 bucks I spent with you solved my problem. Tony Apopka, FL
  • Not only did he answer my Michigan divorce question but was also able to help me out with it, too. I have since won my legal case on this matter and thank you so much for it. Lee Michigan
 
 
 

Meet The Experts:

 
 
 
  • Tina

    Lawyer

    Satisfied Customers:

    8436
    JD, BBA Over 25 years legal and business experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/MU/multistatelaw/2011-11-27_173951_Tinaglamourshotworkglow102011.64x64.jpg Tina's Avatar

    Tina

    Lawyer

    Satisfied Customers:

    8436
    JD, BBA Over 25 years legal and business experience.
  • http://ww2.justanswer.com/uploads/RA/ratioscripta/2012-6-13_2955_foto3.64x64.jpg Ely's Avatar

    Ely

    Counselor at Law

    Satisfied Customers:

    19941
    Private practice with focus on family, criminal, PI, consumer protection, and business consultation.
  • http://ww2.justanswer.com/uploads/FL/FLAandNYLawyer/2012-1-27_14349_3Fotolia25855429M.64x64.jpg FiveStarLaw's Avatar

    FiveStarLaw

    Attorney

    Satisfied Customers:

    8189
    25 years of experience helping people like you.
  • http://ww2.justanswer.com/uploads/jespoag/2008-12-17_222355_jessepic.jpg JPEsq's Avatar

    JPEsq

    Attorney

    Satisfied Customers:

    2132
    Experience as general attorney, in house counsel, SSDI, Family Law attorney, and law professor
  • http://ww2.justanswer.com/uploads/gsenmartin/2008-04-22_214950_me1.jpg Guillermo J. Senmartin, Esq.'s Avatar

    Guillermo J. Senmartin, Esq.

    Attorney

    Satisfied Customers:

    110
    7+ years of experience handling various legal matters.
  • http://ww2.justanswer.com/uploads/PA/PaulmoJD/2013-10-10_195858_JAImage.64x64.jpg Law Educator, Esq.'s Avatar

    Law Educator, Esq.

    Attorney

    Satisfied Customers:

    31621
    JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
  • http://ww2.justanswer.com/uploads/dkaplun/2009-05-17_173121_headshot_1_2.jpg Dimitry K., Esq.'s Avatar

    Dimitry K., Esq.

    Attorney

    Satisfied Customers:

    15975
    Multiple jurisdictions, specialize in business/contract disputes, estate creation and administration.
 
 
 

Related Legal Questions

Chat Now With A Lawyer
Joseph
Joseph
1160 Satisfied Customers
Attorney with significant and substantial experience in multiple areas of law.