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RE: I've had it with insurance companies - 12/6/2009 5:11:33 PM

housesub4you

Posts: 1879
Joined: 4/2/2008
Status: offline

Yea, tomorrow it all begins

Thankfully for us, we have a family of attorneys (something they never forgave me for not becoming) who are all going to raise hell tomorrow.

But I am lucky, cause without them it would be a daunting case. As for the hospital bill, they have all said "Don't Pay IT" let everything take it's course.

It's not the money, it's the power they believe they have over us, that pissed me off.

It's all about power, they believe they can choose who gets covered and who does not, who lives who dies...and people believe the government will be worse???? I do not see how

(in reply to pahunkboy)

Post #: 21

RE: I've had it with insurance companies - 12/6/2009 5:41:55 PM

QuirkyAnne

Posts: 268
Joined: 9/17/2008
Status: offline

Anytime I and my atheist buddy get into an argument over what proof there is of Satan (and other spiritual beings), all I have to do is provide proof that politics and insurance companies STILL exist.

I wish you the best of luck in your fight and I really hope that you win. That is absolutely insane what they're doing to you.

Anne

(in reply to housesub4you)

Post #: 22

RE: I've had it with insurance companies - 12/6/2009 5:43:02 PM

Termyn8or

Posts: 18681
Joined: 11/12/2005
Status: offline

My opinions are just too radical to express here. But in short, if I get a broad knocked up I will feed her plenty of meat, nuts and good wholesome food. She can have the baby on the kitchen table. I will promptly apply for at least five SSNs for the kid, and if it dies it dies. Not a happy situation but my beliefs prevail.

Now you got plenty of ammunition. This is CM, you can't put an email or certain other info in a post, but that company name should not be against TOS. Say it. Make it as public as possible, and get a lawyer of a certain ethnicity who knows how to go for the jugular. Accuse them of fraud, since you did pay the premiums. Same shit works with the IRS. They look all big and bad, but those wolves need their sheep's cothing, and a knockdown dragout lawsuit pretty much bares them. The transcript of almost every lawsuit is a matter of public record, all you have to do is to give them enough rope.

I am not speaking to the exact specifics you must do to win, I simply can't. But it is the way you fight, how you go about it and specifically what actions you take. Of course they will counter, in that way it is like a game of chess.

So which company is this ? Humana, Kaiser or what ? Let us know and we'll tell two friends, and they'll tell two friends and so on, and so on, and so on. Make your case and make it known by as many as possible. That is your best shot.

And if you give a fuck about others, don't accept a settlement. You want a judgement. Even if you lose it can help make your case, if it is public enough.

I know just about every dirty fucking trick in the book. If your hands are clean, use every one of them. Your opponent will.

Life is a quite dirty game. Get used to it before you die. Is this not in some way a fight for life, the life of your kid ? Get out the big guns, everyhing you can possibly do, but if you retain a lawyer make sure he knows about it, about everything. Just keep the blood off your hands.

I have on occasion fought the big dogs, and they should not be underestimated. But their tail fits between their back legs just like anyone else's. Though I walk through the valley of death, I fear no evil because I know it is not all that tough, it just looks that way. Personally I would go straight to court, and not use regulatory agencies, but then, not everyone is a Terminator. You do whatever you have to do.

T

(in reply to pahunkboy)

Post #: 23

RE: I've had it with insurance companies - 12/6/2009 5:47:02 PM

pahunkboy

Posts: 33061
Joined: 2/26/2006
From: Central Pennsylvania
Status: offline

quote:

ORIGINAL: housesub4you

Yea, tomorrow it all begins

Thankfully for us, we have a family of attorneys (something they never forgave me for not becoming) who are all going to raise hell tomorrow.

But I am lucky, cause without them it would be a daunting case. As for the hospital bill, they have all said "Don't Pay IT" let everything take it's course.

It's not the money, it's the power they believe they have over us, that pissed me off.

It's all about power, they believe they can choose who gets covered and who does not, who lives who dies...and people believe the government will be worse???? I do not see how

Better yet.

The attorney can get things moving. If you paid a retainer- I would say beware of those fees... but you have that covered.    :-)

I hope it all works out for you. For now you cant do anything further this evening- so relax.   Enjoy your new dad addition. :-)

(in reply to housesub4you)

Post #: 24

RE: I've had it with insurance companies - 12/6/2009 5:49:31 PM

pahunkboy

Posts: 33061
Joined: 2/26/2006
From: Central Pennsylvania
Status: offline

NO! Do not post sensitive info on a board. NO!

Term- you better rethink that.

If there is litigation- the last thing you do is publicize a strategy.

(in reply to pahunkboy)

Post #: 25

RE: I've had it with insurance companies - 12/6/2009 6:34:07 PM

NeedToUseYou

Posts: 2297
Joined: 12/24/2005
From: None of your business
Status: offline

I'm pretty sure this is a paperwork mix up of some sort, as most insurance Medical insurance policies cover newborns, as long as you register them with 30 days of birth. A pre-existing condition is an impossibilty with a newborn, seeing the coverage is applied at the instant of birth. You just have to inform the insurer within the proper time frame.

What type of plan is this? As this doesn't make any sense at all. I actually worked at the Blue Cross Blue Shield facility that took insurance questions before, and never did I see one major medical policy that excluded newborns, I don't think that is legal, at all actually. Maybe you have supplemental insurance or something, a lot of people don't know the difference.

Here's a link, there is some mistake going on here, as no insurance company would be stupid enough to commit a lie of this magnitude over an obvious coverage claim.
http://www.insurance.illinois.gov/HealthInsurance/newborn.asp

Now, they may very well be stating your coverage is invalid, which would then lead to no automatic coverage of newborns, as the coverage was entered into under false information, which is 100% legal. Heart murmurs exclude you from tons of insurance policies.

Anyway, it sounds like this is not about the baby, but about false or erroneous medical records. Now, if you have had this coverage for awhile, (I forget how long now), but after x number of years coverage is held, even false information about pre-existing conditions becomes moot.

I don't work in insurance anymore but did for several years, and had to take license exams ect... look up policy information. Call the claims department.

Summay, IMO, this has nothing to do at all with them not covering the newborn, that is just a consequence of either false information on the application (renders contract void), or erroneous medical record (not likely, in all honesty).

So, if you want this to resolve, you have to submit something showing you don't have a heart murmur. Most of those application if not all state, in the last five years have you been diagnosed, or treated for a __________. Now if you can submit some form of proof that you don't have the condition, and you were checked and did not have the condition at the time of application, and show before then that you did not, then they will have to accept you. If you never have had your heart checked since birth at all (not likely), that diagnosis would still hold, however, if even in high school or whenever, (if that was the last time you had an exam), it showed no diagnosis, your claim and insurance will eventually line out.

(in reply to housesub4you)

Post #: 26

RE: I've had it with insurance companies - 12/6/2009 6:38:36 PM

housesub4you

Posts: 1879
Joined: 4/2/2008
Status: offline

Ahh... to be alone in the world, whatever you think you think.

I will not fall for such BS as you seem to live with, I use to actually read what you wrote, but no longer. Your own words tell who you are, no one i would ever care to chat with again

And pahunkboy: Do not worry, for I do not follow the words of the foolish and lonely

(in reply to Termyn8or)

Post #: 27

RE: I've had it with insurance companies - 12/6/2009 6:44:32 PM

housesub4you

Posts: 1879
Joined: 4/2/2008
Status: offline

We had the same coverage for 7 years, they covered everything up until this weekend and never has this been an issue. My heart murmur, I have never had it detected or been in issue in the 49 years I have been alive, I had been hospitalized for broken bones, more bones and never has the concept of a heart murmur ever been raised

So as I said, tomorrow the legal battle begins, thankfully I have enough legal talent in the family so I will not have that burden

(in reply to NeedToUseYou)

Post #: 28

RE: I've had it with insurance companies - 12/6/2009 6:51:34 PM

NeedToUseYou

Posts: 2297
Joined: 12/24/2005
From: None of your business
Status: offline

quote:

ORIGINAL: housesub4you

We had the same coverage for 7 years, they covered everything up until this weekend and never has this been an issue. My heart murmur, I have never had it detected or been in issue in the 49 years I have been alive, I had been hospitalized for broken bones, more bones and never has the concept of a heart murmur ever been raised

So as I said, tomorrow the legal battle begins, thankfully I have enough legal talent in the family so I will not have that burden

My point is ultimately, all this is is faxing a couple medical exams to them. All this talk of lawyers is going overboard. Insurance is fairly straightfoward.

Insurance: You have heart murmur, see it says here 49 years ago. Prove Otherwise.
You: Here are my physical exams 7 years 10 years ago.
Insurance: We'll examine the information.
You:okay
Insurance: In light of the information presented we removing the hold on your coverage. Please call again if you have any questions.

Anyway, you can lawyer up, I suppose, it's completely unnecessary unless you do have a heart murmur, and in that case you will not win. (edited to add, unless you can find the limitation requirement for pre-existing conditions, and you've exceeded it)

Just send them the physicals, and calm down.

< Message edited by NeedToUseYou -- 12/6/2009 6:59:23 PM >

(in reply to housesub4you)

Post #: 29

RE: I've had it with insurance companies - 12/6/2009 6:58:02 PM

housesub4you

Posts: 1879
Joined: 4/2/2008
Status: offline

That is easy to say when it is not your child. I hope it is as simple as you say, but so far it has not been.

They say NO coverage, the hospital asks for payment, they really do not care about anything else.

It I'm right or wrong, makes no difference tonight, it is my check the hospital took to make sure my child was cared for.

Tomorrow is another day

(in reply to NeedToUseYou)

Post #: 30

RE: I've had it with insurance companies - 12/6/2009 7:07:23 PM

NeedToUseYou

Posts: 2297
Joined: 12/24/2005
From: None of your business
Status: offline

quote:

ORIGINAL: housesub4you

That is easy to say when it is not your child. I hope it is as simple as you say, but so far it has not been.

They say NO coverage, the hospital asks for payment, they really do not care about anything else.

It I'm right or wrong, makes no difference tonight, it is my check the hospital took to make sure my child was cared for.

Tomorrow is another day

I know, it's stressful, I used to deal with this stuff all day. However, how long would it take you to call the last few places you had a medical exam at? A day or two. If you go to court it will take much longer. So, if you can provide proof, then send it, you'll want to call the insurer to ask for the information they will want referenced on the submitted information like policy number, case reference number, or whatever they'll need on it to route it properly once received. Then you can fax it to them, and send the copies by mail if they want it, more than likely they'll call the office that supplied the information, and verify it's legit.

For what it is worth that is my advice based on what's been said. If that doesn't work then lawyer up. If you don't have a heart murmur, then I wouldn't pay the medical bills, as the insurer will eventually pay them. You need to keep paying your premiums though, regardless, if you are in the right.

(in reply to housesub4you)

Post #: 31

RE: I've had it with insurance companies - 12/6/2009 7:16:36 PM

housesub4you

Posts: 1879
Joined: 4/2/2008
Status: offline

I get what you are saying. But they have the power, they have covered my family for 7 years, including a child, and surgery on me. And this issue has never been raised. They claim I had it when I was born, but nothing ever including military records says I ever had one.

But, they are in charge and now I must prove otherwise. How, by the medical records they already have??

I'm sure it will be resolved with really no legal battles, but like I said, it is not your child, and when you are pushed up against a wall into a corner you fight back, which is most likely what they want to use against me

(in reply to NeedToUseYou)

Post #: 32

RE: I've had it with insurance companies - 12/6/2009 7:16:42 PM

CassandraAlexis

Posts: 44
Joined: 5/17/2006
Status: offline

You know you are right and the insurance company is wrong. So follow your attorneys advice and dont pay anything. Stop talking to them on the phone, do everything in writing. Keep copies of everything. If they want to collect, they will send to collections and you send them the same letter that you are disputing the charge since you have insurance. If they take you to court to get a judgment to collect, your attorney will use what you have in writing and counterclaim against the insurance for their non payment of the bill. So stop worrying about the hospital bill. Eventually the insurance will have to pay, even if it is years from now and the Court has to get involved.

As for the insurance company, let your lawyers do their thing. Ask them about writing to the state insurance board. Usually that is something that they want to hold off doing for a bit so they can use it as leverage against the insurance company. You have a family of lawyers, use their expertise and who they can refer you to who specializes in such things. Insurance companys not wanting to pay is not usual. Happens about 90% of time in personal injury hospital/medical/prescrition bills. The hospital should be used to it, it isnt a new thing for them to have to wait to get paid due to an insurance company.

Whatever you do though, EVERYTHING in writing via snail mail, email or fax. Keep copies of EVERYTHING. Staple envelopes onto the letters. Write on the top of everything the date you receive it. If you mail it, keep copy and use certified return receipt mail and staple it all together so they have to sign for it and you can print a copy of the tracking. A papertrail is imparative.

(in reply to housesub4you)

Post #: 33

RE: I've had it with insurance companies - 12/6/2009 8:23:50 PM

Termyn8or

Posts: 18681
Joined: 11/12/2005
Status: offline

"Insurance: You have heart murmur, see it says here 49 years ago. Prove Otherwise.
You: Here are my physical exams 7 years 10 years ago.
Insurance: We'll examine the information.
You:okay
Insurance: In light of the information presented we removing the hold on your coverage. Please call again if you have any questions. "

Hold on here, how the fuck come you didn't know all this when you cashed my checks that I faithfully sent in on time for years ? How come when it comes time to pay up all the sudden you know this ? You didn't know this when you spent my premiums on your 35th addition to you fucking ivory backscratcher collection ! All the sudden when it comes time to write a check instead of cashing it you just regained your memory and intelligence ? All the sudden like that huh ?

And Hunky, when things are like this publicity helps, you might as well tip your hand because a motion of discovery will force that anyway.

I almost wish I had a license to practice law, because I would tear them a new asshole so fast their head would spin.

This is fucking bullshit, you have to be healthy or you don't get insured ? Bull MOTHERFUCKING shit. That is typical of the rich parasites we need to draw and quarter in this country, I get the profit, YOU take the risk. Fucking bullshit I tell you and yes, I AM MAD AS HELL AND I'M NOT GOING TO TAKE IT ANYMORE.

I am really sick of how we are treated by big business, and what is SUPPOSED to be our government.

Yes I am pissed. I admit it. With my self control of course I will not cause trouble at this time, but the day may come. And when it does, watch out. Give me the name of that insuranc co and if the time comes I might make their home office look like the Alfred P. Murrah building over there. Oh wait, there is no visual example because it is gone.

Let me reassure y'all that I will not do that, because it is stupid. But be aware, if it ever becomes smart, just stay out of the way. It became smart for old Washington and Jefferson and who(m)ever to start their shit back in the 1770s. I assure you that I am nowhere near as sane as those Men.

So, OP, up with the companies name, I'll tell two friends etc.

T

(in reply to NeedToUseYou)

Post #: 34

RE: I've had it with insurance companies - 12/6/2009 8:28:06 PM

Lucylastic

Posts: 40310
Status: offline

Housesub, Congratulations to you and your wife on your babygirl, I wish her a long life of happiness and health.
I hope everything works out asap regarding the claim issue, the last thing you need to be worrying about is some damn lousy assed health insurance company bozo and a loophole.
Make the most of your time with your babygirl , they grow up soooooo fast:)
Congrats again
Lucy

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(in reply to CassandraAlexis)

Post #: 35

RE: I've had it with insurance companies - 12/6/2009 8:42:46 PM

housesub4you

Posts: 1879
Joined: 4/2/2008
Status: offline

Yea ok Term sorry not buying your BS, not going to play your make the victim prove they are right game.

Thanks LL

It will, I am sure. at the moment she is doing fine and that is all thatmatters tomorrow is another day.

(in reply to Termyn8or)

Post #: 36

RE: I've had it with insurance companies - 12/6/2009 9:27:27 PM

Termyn8or

Posts: 18681
Joined: 11/12/2005
Status: offline

Sorry you feel that way house. Really. What I tried to get across was the fact that they care not for you or your's. That you have to fight with everything you got. If that doesn't fit your way of life, sorry.

Do what you have to do buddy.

T

(in reply to housesub4you)

Post #: 37

RE: I've had it with insurance companies - 12/7/2009 6:20:05 AM

Hillwilliam

Posts: 19394
Joined: 8/27/2008
Status: offline

Right now insurance companies are spending about 1.4 million every DAY to fight health care reform. I have a feeling they arent doing it cause they care bout lil ole Me n You

(in reply to pahunkboy)

Post #: 38

RE: I've had it with insurance companies - 12/7/2009 6:48:41 AM

calamitysandra

Posts: 1682
Joined: 3/17/2006
Status: offline

First the important part:

Congratulations on your new babygirl!

May she have a happy, healthy, and long live.

I can add no advice on how to deal with the insurance company, the German system is completely different.
But I am sorry that you have to face something like this at a time at which all your concentration should be on your family.

_____________________________

"Whenever people are laughing, they are generally not killing one another"
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(in reply to Hillwilliam)

Post #: 39

RE: I've had it with insurance companies - 12/7/2009 10:55:53 AM

pahunkboy

Posts: 33061
Joined: 2/26/2006
From: Central Pennsylvania
Status: offline

Oh man. I did not want to fuel a fight here.

Now I feel responsible for it.

Often I understand Terms posts.   The past week tho- they seem abit abstract.   But he is free to his opinion- and alot of things he is 100% correct about.

In the above matter tho- loose lips sink ships.   The OP has an attorney.   We can offer our thoughts but on his part- he must be guarded at to what he posts on a public message board.

This is no time for egos and locked horns.

It is a time to use ones energy in an efficient manner.

Back to Term- I feel he does have talent- I am sure he can get a good punch on the system- but on this particular matter- the stakes of being wrong are just not an acceptable risk.

Hot air on a message board will not resolve this. Key and strategic action- but such that is not showing the opposition what the plan is... tho- having an attorney is a good statement.

I ram the silver boards- and also a bankruptcy board. I can tell you the other side watching and derails. Collection people on the bankruptcy board- and big banks on the silver boards.

So- gentleman- cooler heads must prevail.

(in reply to calamitysandra)

Post #: 40

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