Legal Question in Insurance Law in Pennsylvania

I originallly filed a health insurance claim in 2004 which was denied. Before undergoing the treatment, for which my surgeon gave me a prescription, I contacted and was told by the insurer I was covered for the treatment . Is it too late to appeal the denial?


Asked on 8/08/09, 10:10 am

1 Answer from Attorneys

Richard Teitell Richard K. Teitell, Esquire, P.C.

I cannot provide you with a definite answer without reviewing documents. You have a Statute of Limitations issue. The law provides that you have a certain time period to file with the court a law suit. Among other claims, you have a contract case. The law in PA generally provides 4 years to file a law suit in a breach of contract case. The 4 years starts from when the breach occurred. However, the health ins policy may provide a shorter or longer time period. Also, if it was a group policy with your employer another law nicknamed ERISA may be implicated. You will need to have an experienced lawyer review this matter. You can contact the Bar Assoc in your county and request to contact the Lawyer Referral Agency. Good luck!

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Answered on 8/13/09, 3:15 pm


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