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Health Insurance Claim Issue

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  • 18-09-2012 7:56pm
    #1
    stevie123c
    Registered Users Posts: 24 ✭


    I'm little livid at the moment so I think the best way to go through this is to give the facts and then ask for advice.

    - Joined health insurance company in Nov '11
    - Went to dentist in December with toothache, turned out to be gum infection. Recommended that molars may need to be removed to prevent recurrence
    -See specialist in early '12 . Recommended removal of molars as well. Asks if I have insurance, when did I join them and when was the original recommendation given. Give him all the details and he says I'll be covered.
    - Schedule date for surgery and contact insurance company to ensure I'll be covered. They say I will be but there is a price drop off of 255 to be paid out of my own pocket for the hospital I've chosen , this isn't a problem.
    - Two weeks before surgery I call again just to ensure I'm convered. Again told I would be.
    - Have surgery in early April
    - Today on the 18th of September I receive an invoice from the consultant/surgeon and a letter from insurance company informing me due to the information received with my claim the symptoms of my condition (having teeth) were present before joining them and they won't be paying.

    What's my next step ? Who can I contact for help ?
    Do I have a case?


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