Legal Question in Insurance Law in Louisiana

Health Insurance

A person is covered by health insurance on a specific date. The provider does not file a claim until 8 months later. During this time, the person covered changes jobs and the company she did work for cancels group coverage for ALL of their employees. Now the insurance company refuses to pay the medical bill even though the employee was covered at the time the medical bill was made. Can they do this?


Asked on 12/27/02, 5:28 pm

1 Answer from Attorneys
Andrew Casanave Andrew M. Casanave

Re: Health Insurance

If this insurance is an ERISA benefit policy (and most employer provided health insurance is) then the key is the language on the contract between the employer and the insurer.

If this is true private insurance (very rare these days), then the insurer must pay.

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Answered on 12/27/02, 8:17 pm


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