Legal Question in Insurance Law in California
Medical Insurance Not Reinstated
I own a small Corp and offer medicl coverage for the employees. I informed my medical ins agent when my company changed banks so they could auto withdraw from new bank. They offered to switch my company coverage to a lower rate policy, I agreed. They forget to start auto withdrawing from the new account and dropped us due to non payment. Now they refuse to reinstate my old policy. They insist I start a new policy but they refuse to cover pre existing conditions that they covered originally. They are demanding all the medical records from doctors we saw while we were under their medical coverage...records they should have but say they don't.
Do I have any legal rights?
2 Answers from Attorneys
Re: Medical Insurance Not Reinstated
Yes, and it may be against the new insurer as well as its agent (your broker.) The paperwork will show what you and they agreed to, including withdrawals from your bank. Who is the "they" who forgot to withdraw from the account - the insurer or the agent? Or was it the bank? And what about the customary late notices - didn't you get any warning?
You should have a lawyer familiar with this area review all of the documentation.
Re: Medical Insurance Not Reinstated
Yes, though your question is a bit vague and doesn't provide enough information to determine whom you have rights against.
You say the agent agreed to these changes, but you don't say whether he is the insurer's agent or yours. It is also unclear to me whether the new policy was supposed to be with the same insurer, or whether you actually signed the new policy. It also isn't clear who failed to perform the automatic transfers -- the first insurer, the second insurer (if there is one), the agent, the bank or your company.
You need to sit down with a competent lawyer to review the details of what happened. Please feel free to contact me if you would like.
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