Legal Question in Insurance Law in California
Paid for school sports ins. and school never turned in money now claim denied
I paid a $200.00 premium required by my sons high school to cover my son for injuries incurred during high school football since I had no other medical insurance. My son was injured and when I took him to the doctor they contacted the insurance co and were told I was not covered because no payment was received. I called the school who didn't admit to it nor deny it but they never turned in the check which they had for almost a month. It was received by the ins. co. 2 days later. The school said they would take care of the bill but now they are saying they won't because I didn't go to the office first to get a claim form which isn't required. I don't know who to go to now.
2 Answers from Attorneys
Re: Paid for school sports ins. and school never turned in money now claim denie
If the insurance policy was purchased through the school and it handled all of the transaction, California case law makes the school the agent of the insurer and thus the insurer can be held liable. The school is also liable. Do not accept any refund checks if sent - and since the school is now stonewalling you, I suggest a few letters from a knowledgeable attorney will get all of your son's bills and your other expenses paid.
You should write the insurance company and send copies of all bills demanding payment and require a written response. Do the same to the school, but demand the school give you copies of all of its paperwork with the insurer which will establish the agency. Do not discuss this on the phone - make the insurer and the school write their positions.
Remember that any claim against a public entity like a school must be filed very soon, so do not let this matter languish.
Re: Paid for school sports ins. and school never turned in money now claim denie
Obviously, you took comfort in knowing that sports injuries would be covered and, therefore, you let your child play intramural sports. The school should be responsible for the medical bills and his pain and suffering. Certain short statutes of limitation apply if it's a public school. You should talk to a personal injury attorney immediately. Good luck, and I hope your son is feeling better.
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