My question involves insurance law for the state of:
Called health care Insurance representative and asked if my policy covered a procedure. I was told it did.
Had procedure. Insurance denied claim. Says it is stated in my Certificate of Coverage that the procedure is not covered. Furthermore they state that while on Phone with the company rep that I was put on hold and during that time a prerecorded announcement informed listeners of the Certificate of Coverage.
I relied on a representative of my insurance and believed all information to be correct.
The insurance company is not disputing the fact that their representative gave me the information, they have their recording of the conversation, they are saying it was my responsibility to read the Certificate of Coverage.
What can I do?
Called health care Insurance representative and asked if my policy covered a procedure. I was told it did.
Had procedure. Insurance denied claim. Says it is stated in my Certificate of Coverage that the procedure is not covered. Furthermore they state that while on Phone with the company rep that I was put on hold and during that time a prerecorded announcement informed listeners of the Certificate of Coverage.
I relied on a representative of my insurance and believed all information to be correct.
The insurance company is not disputing the fact that their representative gave me the information, they have their recording of the conversation, they are saying it was my responsibility to read the Certificate of Coverage.
What can I do?
Health Insurance: Procedure Denied After Verbal Authorization
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