Legal Question in Insurance Law in New York
Denial of claim for a dependant
When my son was born, all hospital charges relating to his delivery and hospital stay were filed by the hospital to the insurer. The insurer paid all claims except for the one pertaining to the nursery care for my son, which was the only claim filed under his name (all other claims were filed under my wife's name). According to the insurer, my son was not added to my policy, thus forming the basis for their claim denial. However, the failure to add my son to my policy was the result of an error by the insurer, and for this reason I feel that the claim was wrongly denied. Therefore, I am now attempting to appeal the denial of claim with the insurer. However, I have been informed by the insurer that there is little chance that the denial will be overturned. Therefore, I am wondering if there is any legal basis for a suit against the insurer, in order to recover the costs of my son's hospital stay. I believe that because the failure to add my son to my policy was the insurers fault, I might have the opportunity to recover these funds.
Thank You.
1 Answer from Attorneys
Re: Denial of claim for a dependant
You should have an attorney review your insurance policy. If the nursery expense was medically indicated for your wife it should be covered. You should also speak to your insurance agent who placed the policy.
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