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Thread: Insurance problem

  1. #1
    God/dess VenusGoddess's Avatar
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    Default Insurance problem

    I'm having an issue and I really don't know how to proceed at this point. I'm hoping that someone can give some advice...

    Our insurance with one of the companies that Joe was working for started in December 2006 (shortly before Adrian was born). We paid almost $900 a month. Now, after Adrian was born, we had problems with the insurance company covering anything. On a $202 invoice submitted, the insurance company paid $18.47 and left the rest for us to pay (this would be in addition to our co-pay, our yearly deductible, and our premium for the insurance). We now have a $400 bill from our doctor that the insurance has NOT paid.

    After numerous phone calls, I am told by the insurance company that I need to speak with the plan administrator. Well, the problem is that this company went belly up back in March/April. The phone number for the company is still active, so I left several messages. Nothing. Finally, pissed off, I called the insurance company back and spoke with someone else...after putting me on hold for several minutes, she comes back and tells me that Joe's company hadn't paid any premiums since November 2006. That would be a month before our insurance was supposed to start. So, we paid insurance for 4 months...to the company (the money is taken directly from the check) and they never paid the insurance. They just kept taking the money. NOW...where do I go from here?

    Do I contact a lawyer and see if there is any way that I can go after them? It's not just about the $400, it's about them taking $900 a month ($3600), in addition to leaving my family with no adequate coverage without telling us so. I also know that if they were doing this to us, they were doing this to every single employee at that company...that's a lot of money. The plan was finally terminated on March 31st, however all of the employees were told that the insurance was paid up until the end of April...

    Any advice, ideas??

  2. #2
    Featured Member lunchbox's Avatar
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    Default Re: Insurance problem

    That's really shady. If they are belly up, you need to find out where the bankruptcy precedings are taking place, ASAP before what money they do have is gone.

    Technically that is theft. You might try to contact the DA's office. You shouldn't need a lawyer unless you want damages paid in excess of what they stole.

  3. #3
    God/dess VenusGoddess's Avatar
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    Default Re: Insurance problem

    Thanks, lunchbox. Do you know how I would find that information out? My old boss is out of the country (vacationing in New Zealand) until late July...so I don't really know who else could get this information for me. I've searched online and haven't found anything there, either.

  4. #4
    Veteran Member Robertjordan's Avatar
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    Default Re: Insurance problem

    That's a bad situation I agree. I'm not sure if this applies in every state but I'd think that the insurance company would have to issue you a cancellation notice. Here in Florida they can cancel you with 15 days notice of non-payment, BUT they have to issue you notice, they cannot simply cancel you retroactive. You should contact your state's insurance commissioner's office. They regulate the insurance industry and typically have experience in these kinds of matters PLUS they are usually an advocate for the consumer. In the meantime gather all the records and documentation you can from when you signed up to letters from the insurance company, etc.

    Also, don't pay the doctor or hospital. Tell them that you had insurance and that you've contacted whoever (state, lawyer, etc) so they're going to have to wait for payment. Fortunately its only a small amount.

    http://www.idfpr.com/DOI/Default2.asp

    Also, what insurance company are you talking about?

    EDIT: I'm adding things as I think of them. This will be my last one:
    Your old company is out of business and the insurance company is still in business. You, as the little guy (gal) need to protect yourself as best you can. In this case it means requiring the insurance company to live up to their obligation. Chasing after your old employer for money is one way to go but in my opinion your better off going against the insurance company. They have more to lose and you'll have the weight of the State Dept of Insurance on your side. Call them and find out how they can help.
    Last edited by Robertjordan; 06-28-2007 at 10:49 AM.

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    God/dess VenusGoddess's Avatar
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    Default Re: Insurance problem

    Ok...here is an update. I spoke with the insurance division of the IDFPR. They told me it was an employer issue as the insurance company would not be liable for paying those bills if the employer is not paying them.

    I am currently on hold with the Illinois Dept of Labor Benefits division.

    The aggravating thing about this (and this is why I had Joe cancel all insurance) is that all $3600 could have gone to pay the doctor and we'd have been done with it. And, people wonder why I hate insurance (in this case it's not the insurance company's fault, but the employers) and trusting employers to do something that they don't do.

    I'll update as I find more.

  6. #6
    Sitri
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    Default Re: Insurance problem

    I was going to suggest the Ill. Dept of Insurance, but it really is a DOL issue. I would check with the DOI though just to find out if they have any ideas.

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