Legal Question in Insurance Law in Arizona

Appeal for unpaid med ins claim

In 2005 I had med ins with a co thru the state of AZ (I am disabled) and worked for state gov for 15 yrs.There was a contract filled out and submitted to this ins co. I chose coverage without Part A&B of Medicare. They accepted my application. Now a year and a half later I received an appeal from them stating they were not going to pay a surgical procedure I had on 9/21/05, which was paid at that time to my provider. Now, 2007, they decide they want a credit from provider and state I need to pay the amount which is: $3900.00. My premiums were always paid. My question is: Is there a statute of limitations on this claim? I am in debt for thousands of dollars because of this ins co not wanting to pay providers, which are listed in their provider list. What are my options here? TY


Asked on 2/19/07, 4:02 pm

1 Answer from Attorneys
James Jenkins Jenkins Law Center PLC

Re: Appeal for unpaid med ins claim

See an attorney who specializes in "bad faith" claims against insurance companies. If they accepted the claim and paid it, and eveyone relied upon that, and they were supposed to pay it in the first place, I do not see they have a right to make a tardy claim for repayment from you or the provider.

I presume that there are other facts, not detailed here in this limited question, which might have a bearing upon your case. Be prepared to share all the facts with the attorney.

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Answered on 2/19/07, 10:54 pm


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