My health insurance company just rescinded my policy after I submitted claims.?
I applied for an individual health policy and in good faith signed that the information was complete to the best of my knowledge. I also consented to them acquiring any records necessary from my providers. I then had an emergency heart event that resulted in k+ claims. I then cancelled the policy after 5 months since I qualified for insurance through my employer. I just got a letter notifying me that I did not fully disclose all of my health history for the last 10 years on my application, therefore they are rescinding my policy as if it were never in effect. I am now facing k+ in bills and I am going to start the appeal process. How should I respond to the specific items they claim I did not disclose? One of them, for instance, is sleep apnea, which I was never diagnosed with and never received treatment for, but participated in a sleep study to see if I had it.
Tagged with: 10 years • 5 months • emergency heart • good faith • health history • health policy • heart event • individual health • insurance • sleep • sleep apnea • sleep study
Filed under: Sleep Apnea Solutions
~~Send a certified letter with return receipt stating you want a list of every item they are saying you did not disclose, and where they received the information. I don’t think they have proof of any of their claims. Contact your State’s Insurance Commissioner and file a complaint. Do everything right away. This is just and outrageous showing of the awful games these insurance companies play. Make sure you keep great records and try to do everything in writing. Best of luck with this, I hope it is settled and your claims are paid promptly.
Ask for the specific information that they claim you failed to disclosure along with it’s source.
Hmmm. I think the insurance company is just trying to get out of paying now that you have cancelled the policy. Bad sports. Well, one thing, your situation shows why people need to be very careful when they do those studies as it can come back to bite you if you indeed do end up with something. But back to your question, I think you definitely have a case for a lawyer and as the former answerer said, either you or your lawyer should request the information they have on hand that they are using to not honor the claim. Good luck.
Misrepresentations or "false statements" that are significant enough that if the insurer had known the truth, they wouldn’t have offered you coverage, then yes they can rescind the policy since it’s within the contestable period of two years (three years in some states) But sleep apnea doesn’t seem significant enough. I’ve never heard of an insurance company refusing coverage because a person participated in a sleep study. That’s ridiculous.
I’m not sure how to go about appealing that decision though. I’d call the insurance company and inquire about how to appeal that.
You get a letter from your doctor, to say you do NOT have sleep apnea, and never have had it.
You do that for each specific item.