Question:
Insurance refuses to pay after approved surgery.

I had my surgery on 5/10/2006 and now my insurance company claims they did a history review and that on 3/11/2004 my obgyn who had just delivered my child on 2/26/2004 said I was 5'3 and weighed 245 but when I purchased my new insurance due to lose of job on 11/30/004 eight months later I said I was 5'4 and 195 pounds.Which at the time I was.I mean on my lincense it says 5'4,id and everything that always questioned my height I put 5'4.So now they are saying if I can not explain the weight issue and height issue they will cancel my insurance from date of purchase like it never happened. I really do not know what to say I mean I was two weeks from delivering the on 3/11/2006.I guess I had not lost all my baby weight that quickly.Please give me some ideas on how to appeal this matter.They said I can appeal it.Should I get a lawyer?Thanks Kim    — wafflekim (posted on June 19, 2006)

June 19, 2006
Oh good grief! Do they not realize you just had a baby? I'd call them and talk to them, and then if they need more, consider getting a lawyer. Sounds like they are desparately searching for a way to not pay this bill. GRRRRRRRRRRRR Hopefully though a simple explanation will do the trick. Good luck! HUGS! Kimberly
   — Southgrim

June 20, 2006
Of course you weighed more right after having a baby! I would try being nice first (keep a record of everyone you speak with) and , if nothing happens, see a lawyer!
   — Novashannon

June 20, 2006
Forgot to ask: do you have nay officiial verification that you weighed less? I.E. a doctor's office visit, either your gyno yearly or your GP
   — Novashannon

June 21, 2006
I had not been to a doctor since I had my baby so I had no other records to give them except for the doc I have been to recently.I am thinking of trying to get the dept.of insurance to look into it.
   — wafflekim

June 29, 2006
Definitely write a letter tot he insurance commissioner and send it to theoresident of the insurance company too. If you get get a lawyer to write it even better. Do not give up, fight this, you can win. Good Luck.
   — catleth