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Old 12-28-2009, 01:44 PM
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Insurance advise needed.

Ok guys, I need some advise. First off my wife is 9 months pregnant and we are going in to induce labor tomorrow at 7AM. It's a boy and I'm very excited. Anyway, the Dr's office called today and says the Health Ins. Company is refusing to pay for anything. They have paid for weekly visits,labs,ultrasounds,etc all along. We paid our $2500 deductible. Now they decide they're done. Why you ask? Because we switched my wife's health ins policy 2 months before she got pregnant. Better rates, better policy, etc. She specifically asked the agent; when Maternity could be added, to which he said immediatly. So we sign up and start paying the additional maternity premiums from the start. The agent says we're covered so we wait a month(just in case) then start trying. We recieved the contract a several weeks later (prolly 2 months from the time the Ins. went into effect) and filed it away. Now the Ins. company says there's a 90 day wait for maternity coverage, sure enough on page 6 of the contract it states this. It was approx. 60 days @ conception. Well first off the agent lied, misspoke, whatever, and second off I've been paying maternity premiums since from the start, and third, the Ins. company has payed for everything(besides deduct.) thus far. We just found all this out about 2 hrs ago, and needless to say my wife is freaking out. We can scrape, borrow money, to pay for this but thats why we bought good insurance and payed high premiums. We tried to call the agent who "sold" us the policy to see what's up and of course he's out for the day. Sooo, what's supposed to be the happiest day of our lives ( it still will be) we've got to worry about this crap.
We will appeal.

Any other advise?
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Old 12-28-2009, 01:49 PM
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Huh, I would have been better off dropping her health ins. and using the premium money to pay off my truck.
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Old 12-28-2009, 01:50 PM
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I would try to pay for it first and then get a lawyer 2nd, If they are charging you for it and he told you it started right away you should be set.

I am sure somebody who knows more than I do will chime in soon.
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Old 12-28-2009, 01:56 PM
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Well, the wife talked to a differnet agent at the same office and told us to send the ins. company the bill just to see if they would pay it,(they've payed the others), then when they reject it appeal it. He said it would probably end up bouncing back and forth between the agent and ins. company. I just hope the phone conversation was recorded back when agent said we'd be covered immediately.
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Old 12-28-2009, 01:59 PM
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AND why the heck couldn't this mix up be discovered months ago? The day before we have the baby, I mean come on. WTF
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