Re: problems with insurance

[Guest guest]

I too have had problems with insurance carriers there are some

things that people are not aware of.

1. Every state has a regulatory agency that handles disputes and

problems.

2. Alot depends on what type of coverage you have, IE. is your

coverage through an employer and if so are they self insured, what

this means is that all premiums are collected and go into a fund and

these funds are used to pay claims, usually by a company the

employer hires to do this, remember they work for the employer not

the insured.

3. In Indiana if an employer is self insured there is NO

regulatory state agency that has jurisdiction over them, which

simply means if there is a problem NO state agency can tell them

what to do.

4. If the policy is a purchased through a carrier like Blue Cross,

Anthem, they are required to follow the laws mandated by each state.

5. If your problem is through a self insured employer you do have

some recource, try writting to your state rep. ( I did and it got

20,000 dollars worth of hospital bills paid)

6. Look over the policy does it say that there is a waiting

period, some employers will not cover new employees on things that

have occurred prior to there hiring in such as pregnancy that

ocurred before they were hired, and they won't cover it.

7. Did you fill out a health history questionaire after the key

word is after the job was offered too you. Alot of employers require

some sort of testing prior to offering a position IE asbestos

ebatement workers usually have a chest x-ray, pulmonary function

test a very lengthy health history view form basically the employer

is trying to PROVE that this person did not have lung cancer or any

symptom of cancer before they came to work for them, that keeps

there inusrance costs down and also prevents a workers comp claim

against them. If the person has symptoms or problems with any of

these test they may not hire this person, or they may make there

employement contingent on the fact that they will cover none of the

probems caught prior to there hiring. I know this really has nothing

to do with the actually problem but it was the only senerio that I

could come up with to explain, what some employers do to keep from

possibly spending ALOT of money.

Don't sit back and let them take advantage of you, inquire why

they feel that legally they can do this, have them explain and refer

you back to the book or paper (Plan document) so you can read it

yourself.

Atwell LPN