Hi All! My family and I are at a loss of what to do. My sister has sent out her renewal papers for her insurance in March which was due in April. Even though she did this her insurance has been cancelled as of June 30th. They did not send us any letters and it is stated in their computer system that they recieved her papers but somehow it was never renewed. Now they want her to reapply with could take up to 3 months to do so. Right now she is due for radiation. She should have started it this week and we can't get her in because the dr's here will not take her without an approval. My family and I have been trying so hard to ressolve this issue but to no avail. Does anyone have any suggestions to help us? I am so upset that these people could do this to a person when we have done everything right. It is so upsetting to know that my sister is not getting the treatment she needs right now because of this. Thanks for any help!

I would suggest your sister call the hospital/facility where she is getting care and ask to speak with a social worker. The social worker should be able to help figure out a plan and hopefully will advocate for her directly with the insurance company. If they do not have a social work department, she can try calling the American Cancer Society and see if they can help her sort this out. As a last resort, she can try going to the local newspaper/TV station and see if they will put her story out there and embarrass/guilt the insurance company into action.

I'm so very sorry you are all having to go through this.

If they force her to reapply, they may turn her down or not cover for pre-existing condition. This has to be reinstated. If you can't this resolved shortly, I'd get a lawyer and/or call the insurance commsion in your state to find out how to get this resolved quickly and file a complaint.

Take care,
Eileen

Move up the chain at the insurance company just keep asking for the next one above whoever you are speaking. The words they all fear is "Bad Faith Claim" use it everytime you speak with them. That means that they should have paid a claim and didn't or in this case they played with her renewal. If a claim goes to court and the company is found to have not acted in good faith then not only is the claim paid but they are always hit for huge additional amounts as a penatly.
Never yell just keep telling your story if that doesn't work get an attorney!

Thanks for the suggestions. I have called the surgeons social worker who refered me to the hospital social worker. They are trying to get a letter from the insurance company that her insurance will be reinstated and then we can move on with treatment. We are also going to our lawyer tomorrow just in case, to see what our other options would be. We also called the insurance and cancelled her aplication that they told her to fill out last week. Thanks so much for your imput. Hopefully this will be taken care of and done tomorrow. She is week 6 post surgery and I know should be having her radiation treatment starting this week. It is so frustrated that these people can hault her treatment without a care in the world.

As Seda mentioned, "keep telling your story". This is also known as the "broken record method" and often does work. It is also a good idea to be friendly and appreciative with office staff, nurses, etc. or anyone connected to the surgeon or others in charge of treating your sister. Get their names so you can address them personally or mention them favorably to others. Impress upon them the urgency of continuing treatment and how concerned you are. A few tears may even help as well. Ask if there is any way at all that treatment can be established or continued. When my son was undergoing treatment, he had no health insurance, no job and in the middle of divorce. One of the nice assistants at the office put us in touch with a drug company that provided free meds based on need and suitability. The hospital set up a payment plan where we could pay a very nominal amount to each department billing us, some as low as $5 or $10 a month! There are people who do care and when they see how sincere and concerned you are, they will help or will point the way to those that can help.

Hi Susan - My husband is retired from the insurance business but he suggested, if you are not getting help from the above, you should call the state insurance commissioner. He said just Google the insurance commissioner for your state and find a contact to inform of this problem...then tell your story. Let us know what they say. Best of luck.

I am currently in the insurance business. Absolutely contact Ins commissioner. You must do (and should document) all steps with Insurance company. It helps to copy the insurance commisioner (acrually put the cc at the bottom of your letters to the Ins Company. That will get them moving. State in your letters what you want and when you expect a reply. (part of the necessary documentation. The Commissioner will open an investigation nad the ins company has ten days to respond to him/her. It is also free whereas an attorney would not be. You can always use an attorney later if necessary, but I doubt that will be needed.
The insurance commisioner has the power to forbid an insurance company from operating in your state. That is what gets them moving right away.
Keep at it.
regards,
Chris