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Dimitry K., Esq.
Dimitry K., Esq., Attorney
Category: Legal
Satisfied Customers: 41221
Experience:  Multiple jurisdictions, specialize in business/contract disputes, estate creation and administration.
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I just received a bill from my health insurance company. They

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I just received a bill from my health insurance company. They are claiming that I have a past due balance. This is clearly incorrect. I did pay the first month's premium when I signed up for the policy. And I paid the bill they sent to me. But they are not reflecting my past payment on the current bill. I cannot seem to get anybody from Customer service until Monday at 800 am. I am scared that they will now be able to cancel my policy even though I did pay the first month's premium. What are the rules regarding cancelling a health insurance policy for late payment? I did not pay anything late but their billing notice has me incorrectly showing a past due amount. Can they cancel me? I cannot get anybody form customer service until Monday Morning. Am I okay until then?

Thank you for your question. Please permit me to assist you with your concerns. I am a Pennsylvania licensed professional and am very familiar with your situation.

Please allow me to assuage your fears. Under PA law an insurance company has no legal right or basis to cancel your policy without advance notice of at least 30 days. In other words your policy must be past due beyond 30 days before the insurance company could cancel coverage. If their records are incorrect, and they happen to cancel your policy (highly unlikely), they will have to reinstate your policy and provide coverage for the items that they currently cover under the policy. You are perfectly fine until you speak with them.

Good luck.

Customer: replied 4 years ago.

Thank You. I just can't understand why they made this mistake. My policy is a HIPPA Conversion Policy. I was covered under COBRA by my former employer and then the Insurance Company gave me the option for a HIPPA conversion plan. The date the old coverage under COBRA was terminated was April 26 and the HIPPA coverage started April 27. I prepaid 6 weeks in advance my first month's coverage. Then paid an additional payment for the stub period which was May 27-31. Now they sent me the bill for June but are showing a past due amount. And they are showing an amount next to adjustments but no explanation for the adjustment. This is extremily frustrating. Health Insurance premiums are high enough and I complied with their laws regarding payment. Sometimes I feel like the people who work in these insurance companies as billing people are not exactly the most qualified. I guess I will have to call them Monday. What is even more infuriating is that the bill is dated April 25 and I just received it today. Nine days turnaround time. Sorry to go on about this but its frustrating.

Thank you for your follow-up, Richard. You are most welcome!

I can most definitely understand the frustration, especially the slow turnaround times where an error is being made. I also happen to share your sentiment (after working in the insurance industry myself prior to law), that the human resources element, or at least proper and significant training is lacking. Most are trained and taught that if they see something they do not understand, or it requires more research, to flag it, deny it, and let the next person evaluate and potentially get it resolved. You of course only get the denial, the error, or the concern. But you really would have no choice bu t get it resolved first through them or through appeals. It might simply be a situation where the billing was not correctly updated.

Good luck.

Customer: replied 4 years ago.

It may already be resolved. The insur. co did allow me to fill a prescription yesterday on my plan. So I guess they cannot cancel me until the payment is 30 days late. And since my new policy began April 27 that would be May 27th. And all I would have to do is provide the cancelled check from my bank and they would be forced to restate me or I could complain to the People at the State who regulate insurance as I did not do anything wrong. I am guessing this is a regulation. However My biggest problem is paraonia.

Thank you for your follow-up, Richard.

If your prescription was filled, your policy is active. It cannot be cancelled so quickly. While I can understand your paranoia, in this situation you still have plenty of time to resolve this without any adverse actions.

Please be well!

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