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TexLaw, Attorney
Category: Legal
Satisfied Customers: 4430
Experience:  Lead trial/International commercial attorney licensed 11 yrs
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Theres a glitch in my health coverage that the insurance admitted

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There's a glitch in my health coverage that the insurance admitted to. They pay only 80% instead of the agreed to 100% of the claim. It's been almost 5 months since this started. I'm getting medical bills, some providers refuse to see me until I pay them... Insurance refuses to give me the time frame when this will be fixed and keep saying that my case is open and as soon as it is reviewed they will reimburse my providers. Is there something from a legal stand point that I can do? Please advise.

Thank you for your question.

From a legal standpoint, the only thing you can do is file a lawsuit. You would sue the insurance company for breach of contract and assert as your damages the unpaid portion of your medical bills.

Often, a stern letter from a lawyer can resolve this sort of issue. You may consider contacting a local Insurance attorney to handle this.

You can also report the insurance company to the TX Department of Insurance at:

This can sometimes spur the insurance company into performing their obligations.

Please let me know if you have any further questions. Please also kindly consider rating my answer positively so that I am compensated by the website for my work on your question. Rating positively does not cause an additional charge and does not prevent us from further discussing your questions.

Best Regards,
TexLaw and other Legal Specialists are ready to help you
Customer: replied 4 years ago.

Thank you for your advise. Have a blessed day.

Same to you! Thank you for the rating!