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My medical insurance declined to authorize a treadmill

Customer Question
stress test requested by my...
My medical insurance declined to authorize a treadmill stress test requested by my heart Doctor even after two requests to find out if i had any blockage in any artery.
Short time after, 6 months, i have heart attack and had to have procedure to put in a stint due to blockage.
Doctor says he would have found it with the stress test he requested twice.
Im 70 years old and always have been in great shape and make my living in the fitness industry. My entire life has now changed with the stint and medications that cause stress, ED, and side effects. All the above could have been avoided with the spproval of the test my heart specialist requied necessary.
Do i have cause for action?
Thank you,
Danny Russo (###) ###-####
Submitted: 1 year ago.Category: Legal
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Answered in 4 minutes by:
9/7/2016
Lawyer: Dwayne B., Attorney replied 1 year ago
Dwayne B.
Dwayne B., Attorney
Category: Legal
Satisfied Customers: 34,057
Experience: Began practicing law in 1992
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Hello and thank you for contacting us. This is Dwayne B. and I’m an expert here and looking forward to helping you today.

You potentially have a cause of action. If the insurance company was, under the terms of the policy, supposed to cover the stress test then you would have a cause of action. If, instead, the policy did not cover the cost of the test and the insurance company told the truth about what they were supposed to pay then you would not have a cause of action since the insurance company didn't do anything wrong.

The only way you're going to find out is to have a local lawyer look at the insurance policy, the coverage sheets, as well as any other documents.

You can find a lawyer to assist you by going to www.lawyers.com and in the section for Area of Practice enter Civil Litigation or Consumer Law. Either of those will have the skill set you need.

If your question has been answered then I'd offer my best wishes to you and ask that you please not forget to leave a Positive Rating so I receive credit for my work.

Of course, please feel free to ask any follow up questions in this thread. I want to be sure that all of your questions are answered.

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Dwayne B.
Dwayne B.
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Category: Legal
Satisfied Customers: 34,057
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Experience: Began practicing law in 1992

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DISCLAIMER: Answers from Experts on JustAnswer are not substitutes for the advice of an attorney. JustAnswer is a public forum and questions and responses are not private or confidential or protected by the attorney-client privilege. The Expert above is not your attorney, and the response above is not legal advice. You should not read this response to propose specific action or address specific circumstances, but only to give you a sense of general principles of law that might affect the situation you describe. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction to which your question pertains.

The responses above are from individual Experts, not JustAnswer. The site and services are provided “as is”. To view the verified credential of an Expert, click on the “Verified” symbol in the Expert’s profile. This site is not for emergency questions which should be directed immediately by telephone or in-person to qualified professionals. Please carefully read the Terms of Service (last updated February 8, 2012).

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