Will secondary insurance cover claims denied by your primary insurance?
As long as it is a covered expense by your secondary insurance and a claim has been filed with the primarty insurance then the answer is yes. The secondary insurance will only cover the expense according to your plan.
IF Patient primary insurance denied claim because provider is not contracted with them will secondary insurance pay on the claim?
With Primary and Secondary Insurance your primary denied your claim because it was over a year is your secondary obligated to pay?
Yes, subject to the limits in their policy. No. With most insurance policies, there is what is called a timely filing limitation. For my company; contracted providers have 6 months, and non-contracted providers have 12 months to submit the claim. If your primary insurance received the claim within timely filing, you may have the option of submitting the claim to your secondary with proof that it was filed in a timely manner. If that doesn't… Read More
What do you do if your doctor does not submit to your secondary insurance and now its denied for timely filing?
appeal to secondary insurance
I make payments on a vehicle and have insurance in my name but the car is in my brother's name is this legal?
No. The primary insured MUST match who owns the vehicle, otherwise any claims made for that vehicle will most likely be denied.
Relying on insurance can become a problem as various insurers may not pay claims. Time spent challenging denied claims also becomes costly for individuals as well as companies.
Some people opt for discount car insurance and they get discount insurance coverage, claims can take a while to process and sometimes denied more frequently
That would be covered under the terms of your policy. In general that is what supplemental, (secondary) insurance is primarily for. Most "supplemental" plans pay the 20% that Medicare didn't pay only AFTER seeing an "explanation of benefits" statement--i.e. proof that Medicare paid their part. If Medicare denies a service all together, the supplemental plan is often under no obligation to pay at all, as they are there to "supplement" Medicare, not take the place… Read More
all depends on the blue cross plan you have. A lot I come by through my job as an insurance biller the secondary will pick up any copays that medicare wouldn't cover. But there is some plans that won't pay if medicare doesn't pay. So, really, yea, your secondary should pick up some cost. Unless it is just co-pays, they have the choice to make that your responsibility as a member. Do take the time… Read More
A payer of last resort is an entity that pays after any other primary programs have been billed. For instance, after a primary insurance company, a secondary or even tertiary program can come in and pay the last of a bill. In some cases, the patient can no longer be billed for services after this payer has paid or denied payment.
Many insurance companies will denial claims for pre-existing conditions. You have a right to appeal all claims. You should call your company first to see why the clam was denied.
can a person be denied medical servises due to no insurance
What kind of Insurance?
Yes, it can be and no it may not be. You did not give enough information for a determination. Usually, the primary carrier pays their maximum, then the secondary carrier pays some or all of the portion of the procedure that is left BUT not more than the claim itself or more than they would have paid if their contract was primary. Here are some reasons why it could be legitimate to deny your claim… Read More
How much in dollar figures and percentages of Cigna's annual gross revenue goes to paying claims and how much of it goes to paying salaries?
While I don't have the numbers for you, for the most part the money Cigna uses to pay claims is not from their revenue at all. Most employers maintain a bank account of their funds which Cigna uses to pay claims. This is referred to as A.S.O. (administrative services only) funding. Cigna's pocketbook is not impacted by the claims paid or denied for these accounts, which make up the vast majority of their claim volume… Read More
Go to court! If insurance is involved, let the insurance handle it and the insurance adjusters handling the case can make determination of injury based on speed and point of impact on a vehicle. If either insurance company denied them payment for injury, and they decide to sue you instead, they will have to back up their medical claims in a court of law. This typically includes things like: medical reports, x-ray results, CAT scan… Read More
If your thousand dollar claim was denied by the other driver's insurance who should you go after in small claims court?
First you need to be certain of who is legally liable for the damage. Insurance companies seldom refuse to pay damages unless the claim is unsubstantiated. If you have undisputable proof the other driver was at fault, then you can sue that person. -Additional - In most jurisdictions you have to sue the driver/owner and not the insurance company directly. The small claims court clerk can tell you for sure. The insurance company will defend… Read More
This court hears cases in which individuals claim that the Department of Veterans Affairs has denied or otherwise mishandled valid claims for veterans' benefits.
If auto insurance states that the discloser and acknowlegment was not filed out complete and they are denied to pay the claims can you bill the patient?
Yes, You can bill the patient. All the bills are the responsibility of the patient anyway. The patient can contact their insurer if they think it should have been covered.
Claims are more typically denied rather than rejected. If the claim did not fit within the terms of the policy then you might get "reject" somewhere in the response, a more specific question would probably generate a better answer.
That's funny,, No.... If you have been denied a claim, then no settlement is forthcoming. It's been denied. Please see Websters Dictionary , look up "Denied"
you go get a lawyer . :)
Logically, he should not be denied his right of life insurance,even after his act of attempted suicide.But if there was police case,it's better to reveal the fact in the proposal form for consideration of the Insurance Company.
Not legally no. If your teenager resides with you and has a license or permit, They should be listed on your policy. If not, an accident or claim could be denied because the insurance company was not informed of this risk. This is sometimes referred to as "Fraud by Concealment" of a known driver. An insurer does not have to pay claims that arise from fraud. Insurers will often pay these types of claims not… Read More
Yes, he or she should. And further, you should receive an official letter of declination directly from the insurance carrier.
There are a few things you can do if you have a life insurance death claim that was denied. What you should not do is try to dispute the denial by yourself. Disputing death claims should be handled by a professional who has a lot of experience dealing with life insurance denials. So two options: 1. Contact a local attorney who specializes in "bad faith claims" for life insurance. This person should have significant experience… Read More
In Virginia (and in most, if not all, states) there is an insurance bureau (http://www.scc.virginia.gov/division/boi/) to which you can file a complaint if you feel your claim was wrongly denied. Theoretically, they provide some regulation of the insurance industry and protect consumers to some extent.
All policy's have wording such as, ''you must promptly report any and all claims'' file it asap. Waiting only increases your chances of being denied due to the above mentioned condition in your insuring contract.
Can I be denied health insurance due to preexisting medical conditions if my job switches health insurance carriers?
No, because group insurance is normally guaranteed-issue, so they have to insurance no matter what conditions you have.
If your insurance company denies a claim can the state revoke your driver license just as if you were carrying NO insurance?
No, but if the reason that the insurance company denied the claim was because the insurance was not in force, then the license can be revoked for not having insurance, if that makes sense.
Can you be denied Home Owners Insurance or be denied from increasing your current amount of coverage if you have PTSD?
I don't think mental health prevents you from obtaining or increasing home owners insurance. I have never heard of this happening and it seems like it would be unfair.
Generally all policies state that when you enter a state with different minimum liability limits or requirements, then your policy will adjust to the minimum standard of the state you enter. This does not include a situation where you move to another state and do not tell your insurance company. IF this is the case you have committed material misrepresentation or possibly insurance fraud and most likely claims will be denied.
Great question! Most state laws require the insurance company to pay a claim within 30 to 90 days, however there are caveats. The caveat is "unless more time is required". This, of course, allows an insurer to delay as long as they want. If you have a claim that is being delayed I recommend you contact the Center for Life Insurance Disputes. They help people with delayed and denied life insurance claims.
A simple status check can often be done online with many of the major insurance companies, but most of the time you will need to call the insurance company to find out why they have either denied or underpaid your claim. The most common reasons for medical claims not being paid are: No authorization Not medically necessary Not a covered benefit on patients plan No record of claim at the insurance co. past timely filing… Read More
Please give me more information, and I'm sure I can help. Facts of loss? Exact reason they denied your claim? They must give you the reason that your claim was denied, or that you were found neglient. You can file with your company then they can arbitrate the claim for a decision, you can contact the dept of insurance for your state. You can file suit (small claims if under the limit), if you secure… Read More
Yes, but it makes it more difficult to find them once you have been denied. This is why you should always work with a broker!
Not answering an application for insurance has serious consequences. If you 'misrepresent' any information on the application and suffer a claim, then entire claim can be denied.
Every Insurance company has it's own underwriting guidelines. So it just depends on the company.
Electronic claims are quicker and are a priority over paper claims. Electronic claims are less costly than paper claims. Electronic claims save time and money and less chances of errors being done when submitting a claim. Therefore lowers risk of claim being denied.
Does homeowners insurance cover water damage to floors and walls resulting from a pet chewing through a pipe?
You know, I have seen these types of claims paid, and I've seen them denied it will depend on the form you have and policy wording, and exact cause of loss, contact your company immediately and turn in the claim.
Are you responsible for paying a medical bill if insurance company denied payment due to the practitioner's fault?
Can you be denied health insurance due to preexisting medical conditions if your job status becomes permanent and qualify for health insurance?
Usually you won't be denied coverage outright, but expect your coverage to have limitations that will prevent you from making claims directly related to your preexisting condition. If your coverage includes life insurance, expect similar limitations. For example, if you have a heart problem, they probably will not cover any medical expenses from a surgery, but if you dropped a heavy box on your foot at work, they would cover expenses for a broken toe… Read More
No, an insurance company will generally not use the availability of employer-sponsored health insurance as a criteria in determining your eligibility for a private policy. Agent http://www.anyhealthinsurance.com
In California small group plans are guaranteed issue, which means you would not be denied. The HR person of his prospective employer would be able to tell you if they have a guaranteed issue plan. California has the Major Risk program too. If you live in another state, you can check their insurance programs online.
The insurance company has found some record that you have someone living at your residence that you have not denied. Esurance told me they sent an email with a 10 day response time limit, and afterwards issued a policy cancellation notice.
Assigned risk auto insurance is used to cover those drivers that would normally be denied coverage by most insurance companies. They get this form of auto insurance because of State law requiring them to be covered by auto insurance.
Can your insurance cover a person who has your permission to drive but is not in insurance and has a accidents?
The best advice I can give you as an insurance agent is not to allow people who are not listed on your insurance policy to drive your vehicles, ever. This is not to say your company will not cover someone driving your vehicle with your permission but it will bring up questions. Insurance companies are very wary these days about unlisted drivers who have claims driving an insured vehicle. Your policy states that you must… Read More
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