Question:
Has any one file legal action against your Insurance carrier?
It has been 101 days since I fist reqested this surgery. I have grown impatient with my Insurance carrier BC/BS of AL. I know the type of policy I have has paid in the past and I meet all the requirements. PLEASE HELP!!! — Phillip W. (posted on February 17, 2000)
February 17, 2000
Good luck. I agree. BCBS is a pain in the behind! I first
saw my surgeon in October. They sent a letter to insurance.
BC wanted more information. So I spent a week getting alot
of info for them and to save time, I sent it directly to BC.
MISTAKE!!!I waited 6 weeks and started calling. They never
received any information. I have since learned that BCBS
"loses" more paperwork than any other insurance. So I spent
2 weeks getting this info back together and this time sent
it to surgeon who made copies and forwarded it to BC. They
got it this time. Only they need more information. So I send
them more information via my surgeon. That still wasn't
enough. So I sent more! I am still waiting. It's been 2 weeks
since the last letter was faxed. I'm going to start calling
tomorrow. It seems the thing they are most interested in is
what I don't have. Surprise. This is what they say. "Our
medical staff is unable to make a predetermination for the
proposed treatment at this time. In order to make a
determination, our medical staff needs detailed documentation
of supervised non-surgical weight reduction attempts for the
immediate past two years with dates and results. We also need
medical records of the patient's weight measurements for the
past two years. Please send the requested information - blah,
blah, blah. I hope you had this information. If not, I would
suggest getting it together because you'll need it. Good Luck.
— Tina H.
June 9, 2000
i finally hired walter (lawyer) i heard he is goof, just got tired of
waiitng
— rosalinda H.
June 9, 2000
It is my understanding that in Texas Blue Cross Blue Shield are denying WLS
period. I think they are a nighmare, they reciently brought my HMO now I
have to deal with them, the thought of a Lawyer is appealing. But to fight
them one must get the best Insurance litigator around. Very good Lawyers
write the policy and Certificates of Coverage for the Insurance Companies.
I am not saying it can not be done
but it may cost more than the surgery. I intend to fight for
that which I think is my right. The outcome is another story
I feel like I am David aganist Goliath. And you know David did not do so
bad...
— Tamaria W.
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