Health Insurance Refusing To Pay? Call Your Insurance Commissioner!

Not Linux related, but still an observation that may help someone out there.

As anyone who reads my ramblings will know, I spent an entire month in hospital between May and June of last year after a failed surgery for bowel cancer.

After my first of 3 surgeries, I had a heart attack, caused by the pain killer they had me on, which I ended up being allergic to. This required the services of the in-hospital cardiologist.

My wife and I spent the next 6 months after I was home, fighting with Humana Insurance over why they would pay one doctor, but not another. Indeed, every person we spoke to, gave us a different lame excuse, some saying it was coded wrong by the provider, another saying that the provider didn’t even accept Humana insurance. Going back and forth for months before the cardiology practice put me into collections, dropping my 800+ credit score 50 points in the process.

Having little recourse at the moment, I paid the cardiology and other bills myself, money I didn’t really have!

After stewing about the situation for a few weeks, we decided to contact our Florida state insurance commissioner to inquire if it was proper for Humana to selectively pay some of my $490,000 hospital bill and not others. The response from Florida state was swift, personal, and positive!

Indeed, the Florida Insurance Commissioner employee who was tasked with looking into our complaint, called us personally instead of just sending the normal form letter, to let us know how unfair and unprofessional it was for Humana to deny claims that occurred in a hospital that was supposed to be “in network” and on my plan! Florida assured me that refund checks would soon be in the mail to us.

I should add, that Humana’s “third party arbitration company” (excuse me while I fall down laughing) who we first sent our complaint to, of course sided with Humana, saying that Humana was not responsible for paying these bills, even though it happened in a covered hospital!

Personally, I’d like to see insurance companies hit with triple damages to the patient when they do crap like this. How many people out there have been ripped off because they don’t know their rights?  I’ll be contacting my state representative to see if this is possible. It would sure protect us consumers, that’s for sure!

I am so grateful for the work of our insurance commissioner’s office in clearing up this matter, and will say to all who will listen; If you are having payment problems from your insurance company, contact your local regulatory body in charge of them. You may well find that money, back in your own pocket!