Legal Question in Insurance Law in Pennsylvania

medical bills/prexisting condition

my mother's health plan has a pre-existing condition clause for one year on a condition she had surgically corrected the year before. since then, she had 2 more major nose bleeds from a different vessel that required hospitalization at two different hospitals on two seperate occasions. one hospital paid their portion, the second considered it pre-existing. the doctor's have stated the original condition was surgically corrected and these nose bleeds were not related to the original. to date, she has received approx. $47,000 in hospital bills from the hospital not covering her. my mother is retired, on a fixed income, has too much income for welfare and is a year too young for medicare. we have been told that just paying a minute amount to the hospitals is acceptable? is this true? can any action be taken against my mother (parents) for repayment? if these bills remain outstanding in the event of their death, is their property acquired by the hosptial? Would any remaining family be responsible for any outstanding medical bills? Thank you for any assistance you can provide. I am trying to calm down a worried mother. Almost impossible.


Asked on 6/23/99, 4:49 pm

1 Answer from Attorneys

William Marvin Cohen, Placitella & Roth, P.C.

Re: medical bills/prexisting condition

I assume you mean one hospital was paid by the insurance company, the second hospital was not.

I admire your concern and effort to help your mother and calm her fears.

It would be better to see what can be done about getting the denial reversed, than worrying about what the hospital might do to collect the bills.

I'd be happy to discuss the situation with you and your mom. Please feel free to call or reply by email if you'd like to consult. Our firm is interested in insurance bad faith cases and there's no charge for a consult.

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Answered on 6/30/99, 10:14 pm


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