QUESTION
What is the next step of action if I filed an appeal for denied claims 4 mo. ago & still no response from ins. co?
Asked on Mar 16th, 2012 on Insurance - Tennessee
More details to this question:
Claims denied as \"pre-existing conditions (I dont feel they are) & i paid more than $2000.00 out of pocket because of this. The ins. went into effect 12/01/2010 & I had previous coverage from 01/01/2010- 10/01/2012 (lapse in coverage less than 63 days) but was told my lapse was more than 63 days. I called customer service multiple times & rec\"d conflicting info several times.regarding the claims. I sent a letter of appeal on 11/21/2011 & customer service reps have verified appeal was rec\'\'d . I have been told on 2 occasions since filing appeal that they were \"expediting\" the review & would call back with a decision within 1-2 days, but still no response from them
1 ANSWER
I am sorry to hear of these problems. Since you have tried calling and have received no response I would write a letter to the same department you sent the appeal letter to and explain what you have explained here. Enclose again a copy of the appeal letter you sent and explain that you are awaiting a response and have yet to receive one. I would send the letter by certified mail with a return receipt so that you can track it and will know what day they received the letter and who signed for the letter. Keep pushing them and hopefully you will receive a response soon. If you do not, I would contact a local plaintiffs attorney in your area for assistance. It is best to communicate with insurance companies in writing so that you can proof of such communications. Good luck.
NOTE: This response is general in nature and should not be considered legal advice. No attorney-client relationship exists or is formed by this information.
Answered on Mar 19th, 2012 at 5:08 PM