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Maverick
Maverick, Lawyer
Category: Consumer Protection Law
Satisfied Customers: 6392
Experience:  20 years of proefessional experience
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I was just turned down by an insuance company for 2 reasons:

Customer Question

I was just turned down by an insuance company for 2 reasons:
JA: What state are you in? It matters because laws vary by location.
Customer: 1) I am being tested for a condition that I had in 2012 (a back ache) that resulted in a ruptured colon and emergency surgery. I am beginning to experience the same symptoms after a 5 year period of complete remission. Would this be considered a pre- existing condition under HIPPA? I am in Colorado
JA: Has anything been filed or reported?
Customer: No
JA: Anything else you want the lawyer to know before I connect you?
Customer: 2) The rejection letter referred to a prescription I took 1n 2012(?) that was prescribed by the emergency room when I was experiencing this pain as a reason to reject my application. I have not taken those pain killers since.
Submitted: 4 months ago.
Category: Consumer Protection Law
Expert:  Maverick replied 4 months ago.

Welcome to Just Answer! My name is***** give me a few minutes to review your inquiry. Thank you for your patience.

Expert:  Maverick replied 4 months ago.

Under the Affordable Care Act (ACA), group health plans are prohibited from imposing any preexisting condition exclusion. Under this protection, a plan generally cannot limit or deny benefits relating to a health condition that was present before your enrollment date in the plan. However, a plan may exclude coverage for injuries that do not result from a medical condition or from domestic violence. So, for example, a plan generally can exclude coverage for back injuries in connection with an activity like snow skiing. SO, the answer depends on the source of your back ache in 2012.

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Customer: replied 4 months ago.
The back ache was never explained to me and disappeared after surgery. There was no injury then or now.
What about the prescription drug excuse?
Expert:  Maverick replied 4 months ago.

They are probably wanting to argue that the Rx drug was related to a back injury. But if there is no proof of an injury then that argument should also fail.

Expert:  Maverick replied 4 months ago.

P.S. Please remember to assign a positive feedback rating on this so that Just Answer will compensate me for this answer. Thank you.

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