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Related: Culture Forums, Support ForumsQuestion about health insurance coverage
For anybody who might have the proper knowledge: Thanks in advance!
If you are injured on your property and your health insurance contacts you after paying for the majority of your treatment to get your property insurance to pay -and pressure you to file a property insurance claim, are you obligated to respond accordingly and how legal are their actions?
FBaggins
(26,695 posts)Did they say what sort of claim they think you should file?
ColinC
(8,227 posts)Thing is we are no longer covered by home owners insurance (although we were when the accident happened). I assume you cannot do a retroactive claim.
FBaggins
(26,695 posts)... then you could file a claim IF there was something covered by that insurance.
I'm just wondering what they think should be covered.
Progressive dog
(6,861 posts)insurance paying for owners' injuries.
yellowdogintexas
(22,114 posts)and/or state insurance law to confirm if reimbursement by the homeowners' plan is available.
The health plan will want an official denial from the homeowners policy, or a description of what if any benefits there are. If your homeowners doesn't have any coverage, then that is the end of it.
If your homeowners plan has for example a lump sum benefit of $10,000 then the health plan can require that money to be used up before it can begin to process.
This is what happens with auto insurance liability or anything else that involves a lump sum. When I processed medical claims, we would research any accident or injury claim to find out if any insurance of this sort was available. If I recall correctly, we would advise the hospital to submit their claim to the liability company and refund any overpayment back to us.
The lumpsum liability benefit is supposed to pay out first but the carrier pretty much does not know about it at the beginning, and the hospital, doctors, etc certainly don't know.
Have your homeowner's plan communicate with the health plan; they will duke it out and any overpayments will be refunded to the health plan. If there is a benefit, it is most likely going to be applied to the largest bill first which is usually a facility. Hospitals are accustomed to this.