Insurance Question Help Needed!?
I had Weight loss Surgery. My primary insurance denied the surgery stating I diet. I did provide detail information in the region of failed diets. My minor Anthem approved. The insurance person surrounded by my Drs. office stated I'm appropriate to go because I get the approval letter from Anthem. Now Anthem is making Cigna rate for everything and I'm afraid they aren't going to pay for the surgery. What should I do? I've already have the surgery so the bills are rolling in the house - BIG BILLS are coming and I don't hold that kind of money.
Answers:
Insurance have a term call "estoppel," where once they enlighten you they will give coverage or settle up for something, they have to, even if it be a mistake. The only two conditions are that you didn't pull the wool over your eyes in the first place or facts come forward that they could not be aware of beforehand.
If you did not relay them that your primary Insurance carrier denied coverage, that may be bit of it. Or they may only stipulation proof of the denial to support the claim.
I would follow up with them and see exactly what is going on and what they are doing next to your claim.
Other Answers:
sue your second company for not providing the service they agreed to provide.