Legal Question in Insurance Law in California

cancelled medical insurance
Unbeknownst to me in Dec. 2005 I made a 2 cent error on my premium payment for my HMO medical insurance. Today, March 2007 I received a refund check in the mail for one months premium with no explanation. I called the 800 number and was told my account was short by 2 cents and we were therefore dropped from coverage as of 12/31/06 and the check they returned was for my January 07 premium (however they cashed my February checkand billed me for the March payment). The man said there wasn't anything they could do because I had already been dropped from the system. For a year and 3 months I have been paying exactly what they have been billing me, they never added the 2 cents to the current charges and never told me I would be cancelled if the past due 2 cents wasn't paid. The man said he would check with someone else and get back to me by Wednesday 3/21/07. What do I do if they won't reinstate?? What are the laws about cancellation without notice. My husband and I are both senior citizens. My husband has a heart condition and on medication and I am diabetic and insulin dependent. We can't be without medication and medical coverage. Any suggestions you can offer me would be appreciated.

Asked on 3/20/07, 1:03 am

2 Answers from Attorneys

Steven Murray Steven W. Murray, APC

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Re: cancelled medical insurance

Don't cash the "refund" check. Either you or someone on your behalf should write the HMO a letter (to the corporate offices, preferably to its President or Chief Legal Counsel) explaining the facts. Return their check with it. I'd also contact the Department of Managed Heath Care in Sacramento, which has a "help" desk and file a complaint.

If you can't do this, then immediately go see a lawyer who knows insurance law. And keep paying your premiums, even if you have to use your own envelopes and write your ID numbers on each check.

Answered on 3/23/07, 3:34 pm

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