Insurance law question for anyone who is versed in this
Insurance law question for anyone who is versed in this area. An insurance provider was paid incorrectly for many years. Despite the billing dept. making numerous calls to provider reps. they were told that everything is correct in the system and they were being paid correctly. After years of calling and getting nowhere we started writing letters and a director got involved. He told us that the reason none of the provider reps could correct the problem is because of a glitch in the system that made it look to them like everything was being paid correctly. Now that he was involved that he would correct the error and go back 3 years and pay the difference. It amounted to 10's of thousands of dollars. Close to 6 figures in underpayments. There are still outstanding monies that are being worked on. This has caused an unbelievable amount of stress and double and triple work for our billers.Now that we are in the home stretch we are requesting the interest that is due on all the monies paid late. They are not telling us that they only owe interest from about a year ago since the 180 day rule didn't kick in until this director got involved. Despite him acknowledging that we contacted them many times in the past only to be told that we were crazy and everything was being paid correctly.what is the law here? They are citing the contract that states they only need to pay claims that were contested within 180 days. We believe that since they have paid us this mis-paid claims that proves they aren't going by this 180 day rule in the contract and since they did pay late that they owe us the interest all the way back to when they started paying us, despite our first written complaint was only a few years ago.Anyone experienced in this area of law that can tell us how to proceeed?
I was given an answer to a similar question last night,
I was given an answer to a similar question last night, however it may have lacked some of the following details and would like this question answered now that I have provided perhaps a more organized background for the consideration of my question. I am forming an LLC for an online consulting business, as well as developing a couple additional websites for the purpose of affiliate marketing. These additional websites ultimately tie into the consulting. The main site will be a blog, forum, and appointment generator. Revenue will come from any advertising that may be associated to the site once it gains traffic and through contracted consulting. I am building a website to list businesses for sale, and as a affiliate lead generating site for business brokers. Revenue will come from advertising space paid by business owners, and pay per lead affilates. I will have the site linked to the consulting site where I plan to look for opportunities to add value to those businesses by consulting on operations and marketing strategies. The other site will be an affiliate loan leads generator. This site will also be linked to the other sites as it will be gathering information as leads for business loan institutes. I currently live in South Carolina. I have been planning my business strategies for some time, however not until I made the decision to leave my salary position and give my full focus on my business did I plan, or research much on the time of expedition of the LLC as well as what benefits may be available forming in another state. I have looked into Nevada as it appears to have all the protections I would want in a llc, they also offer the series in the llc. I plan on all sites to operate under one llc, and given my interpretation of the series see that as an opportunity to protect each site individually under the operating LLC Name. Is my interpretation correct? Also given I did not research the expedition of South Carolina llc formation, which is 35 days/25 if rushed, the nevada expedition can be done as fast as 2 hours for a fee with normal processing 6-7 days and for an additional $50 it can be done in two. The state filing fee is less than South Carolina as well. The expedition process is important to me, as I wish to set up and fund a business account asap, and want to launch everything under the protection of an llc. I have some cushion financially, but it is limited. All this being said I will be a single owner for this formation. The only potential change I can for see in the next year would to bring in a profit sharing partner. I plan to outsource any work to freelancers rather than have employees for now. Given the information I provided is forming in Nevada a good consideration?
I need to get up and running quickly. I only have so much
I need to get up and running quickly. I only have so much saved without additional income. That being said, South Carolina has a 35 day processing 25 expedited. This is much longer than some of the other states such as Nevada and Delaware. I want all income to flow through a corporation. As well as I want the protection of a corporation for a couple of the websites I will be launching. Suggestion
I have a general contract law question for you. How exactly
Hello,I have a general contract law question for you. How exactly is a contractual provision affected by trade usage / common dealings?For example, a company I deal with has a contract with ALL employees. That contract states that the company shall pay employees a bonus as calculated by the LOWEST estimation of profits. However, to be nice, this company has been calculating a HIGHER bonus by using higher estimation of profits in order to give the employees a better bonus.Now, if the Company decides to fall back on the original contractual language and utilize the LOWEST estimation of profits, is the Company going to be in trouble?If it helps, I'm basically trying to find out how common usage and past dealings would essentially affect the company's decision to now fall back on the original contractual language. I can definitely offer more of an explanation if you need one. Thanks!
I have a arbitration judgment against my small company-Now
I have a arbitration judgment against my small company-Now the lawyer has sent me papers thru the sheffics office that he is filing for a judgment against my old company and now my new company for collection on what he says I owe his company. Do I have to appear at this court date or can I submit a written letter to the court?
Counselor at Law
I am a disabled state employee that is two house payments
I am a disabled state employee that is two house payments behind. The State Employees Credit Union did a 'set-off'. By taking $300 out of my checking account towards my mortgage. I was not prepared for this at all ... They did it last month, too, but I got some of it back. Friday, they did it again. I have about $200 worth of medicines to be picked up at the pharmacy. I have had no meds since Saturday. My problem is that my disability check is protected by the federal government just like my social security checks ...they can't take it. But they did and say they will NOT refund any money this time. Can you help me?
Law Educator, I am using a 3rd party service provider which,
Law Educator,I am using a 3rd party service provider which, among other things, stores my customers contact name, address, phone and email. I have found another service which is lower priced and provides more functions and features.There is no contract or End User License Agreement (EULA). It is just $300 per month, month to month.I feel I am being held hostage, they will not provide all my customer contact data, 21,201 records. So if I change I will have to pay someone to look up each person in the current system and copy and paste them into the new system. This is a large expense. They are aware of this and is how the keep current customers from leaving.Who owns the data? How do I get my records? There must be recent cases around this topic.ps Any new provider I will make sure there is a contract, EULA, I own the data and can export it to Excel.RegardsSam
I am looking for an agreement I can use as a PR professional
I am looking for an agreement I can use as a PR professional to act on my clients' behalf. I will be posting and submitting take-down notices on social networks, purchasing advertising and making other requests on their behalf. So, a general agreement would be good.