Legal Question in Insurance Law in Virginia
Can a insurace give false information and get away with it?
Before I enrolled into this particular health insurance company last year, I asked if the insurace paid for a weight reduction ooperation called the Gastric Bypass. I was told yes. After switching this insurace with my employer, I called to make an appointment with the Dr. that performs this, which was on my list of Drs. I was told that my insurance company stop cacvering this procedure as of January of 1999. My open enrollment was Sept. to Oct. of 1999so I asked the question in between that time.I called the inurace company which later said no. What can I do.
1 Answer from Attorneys
You Can't Rely on Oral Statements
Generally speaking, you cannot rely on the oral representations, or misrepresentations, as the case may be, when there is an insurance contract or summary plan description available. It sounds like you need to get your hands on the actual documents. I would want to see the contract you now have as well as any contract that was available at the time you enrolled.You need to have an atty review whatever documents you rec'd before signing up with this company. I am in Northern Virginia and would be happy to look at this for you--no intitial charge. There is a lot of info at my site about insurance companies. Feel free to visit.
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