Issue Date: October 18, 2009
MoneySmart |
WALECIA KONRAD |
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What to do when your health insurer drops you
Insurance companies often rescind coverage on individual health policies if they think they have evidence that you had a pre-existing condition. If you get an unwarranted "drop letter," take these steps, says Kevin Flynn of HealthCare Advocates, which advises consumers on medical care and insurance claims.
Appeal the decision. Every insurer has an appeals process. Ask a customer service representative how yours works. Usually, you'll have to send a written plea, then follow up with calls or a visit. Work closely with your doctor(s) to provide proof that you weren't sick before coverage started.
Call the state regulator. Each state insurance department has a consumer complaint hotline or help line for problems like this. Your state regulators can provide general advice and sometimes assist with specific complaints. To find your state's office, go on the Web to naic.org, click on "states and jurisdiction map," then click on your state for more information.
Consider hiring help. If you aren't making progress, you may want to use a health care advocate to help you resolve your insurance dispute. Ask your doctor's staff for a referral. Be sure to ask how fees will be determined, and speak with recent clients who can describe their experiences with the advocate.
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