Can I Get Reinstated After Non-Payment of Premiums?

one of my clients who has been a policyholder for nearly 5 years had her policy canceled by my company due to a bogus claim by the insurance company that an attempt for payment was made to her bank and the payment was not remitted. The bank responded by denying the insurance company assertion by stating, no attempts had ever been made to the bank to submit payment. furthermore, if an attempt had been made and the bank holder didn’t have money in her account, the payment still would have been paid since the bank holder carries a 1000.00 overdraft protection clause. In conclusion, the company merely canceled this policyholders insurance plan due to the fact, she had 2 surgeries for breast cancer and the surgeries paid out over 4000.00 which they feel is a risk of having more surgeries by the policyholder so they rid themselves of this risk. Here’s the caveat, the company policy states, regardless of age, health conditions, or the number of claims filed, the company cannot take your policy away…only for non-payment of premium. This is clearly a violation of their rule. And now, since this lady has had cancer which is in remission, she can not get insurance until 5 years have passed. Does she have grounds for a lawsuit?

Does she have a legitimate case for a lawsuit?

My wife and split June 2016. She then dropped her hours at her employer ( this is where and how I was insured ) just below the limit to qualify for health insurance. Therefore my health insurance was terminated. I didn’t even know this for about two months when I went to use a prescription card. I contacted the insurance company immediately to find out why my insurance wasn’t working and that’s when I found out my policy was terminated June 1 of 2016.
Then they enrolled me in cobra. Reason I didn’t know I was canceled timely is because her employers cobra administrator sent all of the paperwork to my wife’s address therefore I was never notified of plan termination nor was I given any specific on cobra guidelines in regards to the law. FYI – when my wife moved out, I notified the HR department at her employer that I was at my address and my spouse was at a different address. All of my health insurance statements, example- explanation of benefits (EOB’s), we’re being mailed to her. Her employer refused and continued to refuse throughout my entire cobra participation to mail anything to me directly – they said everything had to be mailed to the employees address.
As mentioned, I finally was reinstated. Just a few weeks ago, the lady at my office who typically mails my premium to the administrator was on vacation. She neglected to mail the check. When she got back to the office at the end of June, I asked her if she had made the payment and she replied no.
I immediately went online and made an electronic payment for the premium Friday June 30. But, it was not posted to my account until July 5. Therefore I was more than 30 days late with the payment. Also on June 30 my office mailed a paper check and it took them until July 14 to post that to my account.
Regardless of these two payments and emails from them confirming the payments – they have terminated me retroactively to June 1.
I find this extremely unfair. Again, I was never given any paperwork from this administrator in regards to cobra laws therefore I was not aware of the fact that the 30 day grace period was enforced as strictly as it currently is. And again, I made an electronic payment on June 30 ( after 5 PM Eastern time ) and a paper check was mailed June 30. In other words on June 30 I paid for June’s premium electronically and a paper check was mailed for July’s premium.
They said, too bad, you’re canceled and there’s nothing you can do. They said I can file an appeal. They told me this three days ago. They said it will take 10 working days just to mail me the appeal form, he said it cannot be emailed. Once I receive that, they told me it takes 2-3 weeks for them to come to their decision. So, I’m not going to know the result of my appeal until the end of August approximately.

I take prescriptions that cost nearly $2000 per month if I needed to pay cash. There is absolutely no way I can pay for those prescriptions. Some of them are critically medically necessary!

I have no idea when I’m going to do until the end of August. And then if they decide to not reinstate me, who knows if I’ll be able to get another policy since the qualifying event of a ‘loss of coverage’ was technically on June 1, again I don’t even know if I will be able to another health insurance because so much time will have passed since the loss of coverage.

Feel free to share my story and any advice would be greatly appreciated. Thank you.

I was dropped from my plan last spring for nonpayment due to clerical errors on my part. I have no intention of appealing because it was my fault but my question is can I still re-enroll during the open enrollment period in the same or a new plan?

Hello,

My policy was canceled for non payment. However 2 months worth of premium was accepted, and the funds have not yet been reimbursed.

I travel often for work, so I set up automatic payment for my account. I was unaware of an error with my automatic payment until I received an delinquency notice and a request to pay the two months worth of premium (months March – April). In the notice it indicated that my policy would be canceled if the payment was not received by 4/29/2016. I paid the premium immediately by check, and the funds were withdrawn from my account on (5/4/2106). I took this to mean that my policy was not canceled. I come to find out a month later that I am no longer a member, and have not been a member for the last three months (policy canceled as of February 2016). I was not notified of my policy cancelation. The payment i made for the months of April and May still have not been reimbursed. If an insurance company accepts payment, should they then provide services? If their plan was to cancel my plan, I should have been noticed immediately with my check enclosed.

I let my health insurance lapse and honestly I did not realize with everything going on with my mother in laws help. Today I received a refund check and a cancellation date of 02/01/2016. It is with blue cross blue shield. Is there any way they might reinstate me? And if they don’t, what are my options

Was kicked off of my healthcare plan for non-payment due to an incorrect billing address originating with New York State of Health, even though I’m more than willing and able to pay my current and past due premiums.

Never received any bills and was never contacted about overdue premiums despite having provided alternative contact means.

Was cancelled after my first month of coverage, which I paid for to New York State of Health.

Have spent over a month trying to be reinstated and no one within the system can agree on how to reinstate me or with whom the responsibility lies.

Can’t imagine how many others are dealing with the same issue. Seems unbelievable that a system error could leave you without healthcare for an entire year (til the next open enrollment). God forbid something catastrophic happens and you are forced to spend the rest of your life trying to pay for it.

This system is vastly in need of improvement. Wish I could reach someone who was willing to listen and try to help make a change but everyone I talk to seems to either pass the buck or try to put the blame on me.

I have been off work for about 6 months due to a work related injury. Although I receive workers compensation, I could not continue to pay my portion of health insurance premium through my employer. I am told by HR that in order for my health insurance to be reinstated I need to return back to work and work a minimum of 130 hours before I can have my insurance reinstated. I have returned to work with restrictions and work approx. 25 hours a week. Is there a quicker way to have my health insurance reinstated.

Insurance didn’t notify for what they didn’t pay last year