Legal Question in Insurance Law in Texas
Insurance wont split the bill
the insurance company says that the city i work for will not cover a weight loss surgery. the doctors i have seen have told me they recommend the surgery, but the insurance doesnt want to cover it. the insurance company says that the city picked the insurance policy that wont cover weight loss surgery and wont cover it even if it is medical necessity. should i get an attorney to fight the city or the insurance company or do i even have a case. also keep in mind it is a $15,000 to $20,000 dollar surgery. and yes it is for my health and will prevent other serious health risk.
1 Answer from Attorneys
Re: Insurance wont split the bill
the answer to your question lies within the language of the policy. if the surgery is clearly an excluded procedure under the policy and there are no applicable exceptions, then, in my judgment, the matter may be difficult to pursue.
however, i recommend that you hire an attorney to review the policy and give you an opinion on this issue.
i hope this helps, bill featherston
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