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Originally Posted by Riot
What an ignorant thing to say.
Do you not understand the truth that everyone on this list, everyone who has insurance - that includes YOU - has the very same same fine print in their insurance policies?
The fine print that says the contract you bought with money, the contract you signed, is fluid? The insurance company can change the terms of the policy at any time they want, for whatever reason they want? And there is no laws that prevent this?
Do you think you are magically special and it couldn't possibly happen to you, your family, your parents?
You don't think you could be admitted to the hospital for a procedure; and you, the doctor, and the hospital call your insurance company beforehand and get approval from them for payment (you cannot get admitted to a hospital nowadays without payment being worked out beforehand) - and later the insurance company simply changes it's mind, and decides it will not pay?
If your insurance company says you are covered, and that they will pay for this procedure, wouldn't you go ahead with the operation you need, because the insurance company guaranteed to the hospital and surgeon they'd pay for it?
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insurance policy's are "contracts of adhesion". what that means is that one side (the insurer) wrote the contract and gave the other side (you), the option to say yes or no. you can't negotiate the terms offered.
courts will interpret any ambiguity in this kind of contract in favor of the party that didn't write it.
i work for an insurance company (please don't hate me). we never make any kind of serious coverage decision absent this awareness. we have a lot of attorneys and most of the time we pay them to have them tell us "you better cover that".
i work in property and casualty which may be very different than health. i also work in california and not kentucky. but the interpretation of contract law can't be all the different where you are.
if you were told you were covered, depended on that assurance, incurred an expense and the insurance company subsequently reneged, you need to talk to a bad faith attorney. do it as soon as possible.