Legal Question in Insurance Law in Florida

Hi we live in guatemala and my dad has been working with the insurance for over 20 years, he has to get a pacemaker for his heart, and this procedure cannot be done here he has to travel to get it done, the way that the company always worked was they paid 80% we paid 20%. he had the authorization to do this procedure working the same way at baptist,pending the dates the dr gave the appointment and all the traveling arrengements. he has all that now and we he send the confirmation they tell him that the policies have changed and he needs to pay full amount and then get reimbursed. But its a very costly procedure we do not have the money, that why we pay insurance for.. but we didnt get any notice from the insurance about this changes not even when my dad a month ago paid the prime. His life its at stake since he's heart is only workin 28% if this procedure does not get done he could actually die. is there some legal way to work as it always has worked?


Asked on 9/23/12, 3:10 pm

2 Answers from Attorneys
Barry Stein De Cardenas, Freixas, Stein & Zachary

The insurance contract prevails. The course of dealing may have some impact. This all is based on a policy written and enforceable in Florida. You need to seek legal help and provide a copy of your policy so an attorney can review it.

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Answered on 9/23/12, 3:23 pm
David Slater David P. Slater, Esq.

The insurance policy must be reviewed. You must also speak with the Hospital Administrator.

Perhaps they will take a personal guarantee from someone living in Florida.

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Answered on 9/23/12, 3:44 pm


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