Legal Question in Credit and Debt Law in Florida
failure of hospital to file insurance claim timely
received summons re hospital bill over $20,000 incurred 18 months ago. At admittance provided copy of two group medical insurance plan coverages. received statement of balance due 2 months later stating: your insurance carrier has not paid...remit within 10 days or contact us for arrangements. repeated phone calls including messages left not returned. wrote letter after one month stating carrier has no record of claim filed,call me to discuss. no response and assumed claim refiled and paid. insurance will not pay now. any defense?
1 Answer from Attorneys
Re: failure of hospital to file insurance claim timely
Immediately send a letter via certified return receipt mail to your health insurer. Enclose a copy of the summons and complaint, along witl a copy of the correspondence received from the medical provider. Advise the insurer that you demand that this bill be immediately paid. Copy the provider. Keep a copy for your records.
Additionally, you need to timely file a formal response to the lawsuit. See an attorney for assistance.
Assuming the the medical services provided were needed, and the charges were reasonable, then you are legally responsible for the bill(s). However, assuming that your insurance is supposed to cover the charges (look at you health plan booklet), then the insurer is legally obligated to reimburse you, or to directly pay the provider.
Good Luck, Elliot Jay Goldstein (Attorney with offices in Tampa and St. Petersburg)
The above information is provided as a courtesy, without any consideration and without knowledge of the specific facts. Do not rely on this information. Seek a formal consultation with an attorney.
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