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I made a payment for my health insurance coverage that

I made a payment...

I made a payment for my health insurance coverage that included September (back payment) and October (current) but it was late. They cashed the check but then told me the coverage was terminated on October 10th. The check was dated Oct. 14th and endorsed with the statement Credit to the acct of named payee without prejudice. Do they have to honor the contract even if they accept the payment late?

Lawyer's Assistant: What state is this in? And when did the issue begin?

Colorado. I was just made aware of this today when I tried to pickup prescriptions at the pharmacy.

Lawyer's Assistant: Has anything been filed or reported?

No. I have spoken to several people but they say there is nothing they can do.

Lawyer's Assistant: Anything else you want the lawyer to know before I connect you?

I don't think so.

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Answered in 21 minutes by:
10/20/2017
DamienJD
DamienJD, Attorney
Category: Legal
Satisfied Customers: 5,451
Experience: Attorney. Well versed, understanding, friendly
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Hello: My name is ***** ***** I am an attorney. Please give me a moment to review your question. I may ask some questions to clarify issues.

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Was the October payment for the full month of October? Check the invoice. It usually says what time period the payment will cover.

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Customer reply replied 10 months ago
They all just say the month and year - premium. (example Oct 2017 - premium)

Okay. Well, the insurance company cannot have it both ways: they cannot charge you for the full month of October and terminate coverage on October 14th. I wonder whether you can get a reinstatement. Have you spoken to them again about it? By the way, was the October 14th checked cashed?

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Customer reply replied 10 months ago
the check cleared my bank on Oct 19th. I have spoken to several people they all say they are sorry but they said it was not eligible for reinstatement. At best one person said I could send a letter to contest it but no telling how long that would take. Meanwhile I have medicines including insulin that I must take twice a day for diabetes sitting in the pharmacy. They said without the insurance I would have to pay the retail price which is six hundred and some odd dollars. I don't have that money as I used the $621.27 to pay the insurance for the month.

You should be covered for the month of October, or the insurance company must reimburse you for the amount that you are not covered. There should be an internal way for you to appeal the decision within the insurance company. See if you can find out how instead of just sending a letter without knowing to whom to send it and if that person can make a decision. We can continue to discuss.

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Let me know if you have further questions. Best regards.

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Customer reply replied 10 months ago
Yeah, I guess I always assumed that they would have to do one or the other. Unfortunately this is a very time sensitive issue for me and I don't have an extended amount of time it sounds like it will take to resolve this through there appeals channels. I guess I was just wondering if since they had already accepted the payment if they were legally obligated to do more than just refund it.

Well, yes, you can certainly argue that, and you could make a complaint in court with a restraining order so they cannot drop you until a Judge makes a decision. So, you do have a legal argument. You probably would need a local lawyer to help you put all the papers together. Sorry, this is happening to you. It doesn't seem right. Let me knew if you have further questions.

DamienJD
DamienJD, Attorney
Category: Legal
Satisfied Customers: 5,451
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Customer reply replied 10 months ago
Thanks for your help.

You are welcome. I hope it works out for you.

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