Quote:
Originally Posted by DejaVu
Hi Brachial6,
Didn't you have a similar problem last month, with getting the insurer to cover your pain medication?
Your attorney may need to take a different approach, so you (and your attorney) are not going through this every month?
In order to enforce benefits coverage, one must determine the governing body with jurisdiction.
If the company you were working for was self-insured (Federal jurisdiction), call the U.S. Department of Labor, Pensions Division. (Or maybe have your attorney do this. This launches an investigation into the employer, immediately.)
If the company you were working for is not self-insured (State jurisdiction), contact your State Insurance Commissioner's office.
Jo*Mar has offered good ideas, too. I would alert all Senators, Representatives, if possible.
This particular insurer has a negative reputation and is known to jerk people around as much as possible. After years of ongoing harassment, I put an end to it by reporting them to the appropriate agency. Never another problem with them.
I hope you can also receive the benefits due you... in peace. 
DejaVu |
Hi Jackie,
As I had mentioned in my earlier post, first find out if your company is self-insured or not. This can be answered by your company's personnel office and/or by the State insurance commissioner.
If the company is self-insured, their insurance benefits are regulated by federal regulations.
Each region in the U.S. has an office for U.S. Department of Labor, Pensions division. Contact that number and a caseworker will take your complaint.
If the company is not-self-insured, they are regulated by the State insurance regulations, enforced by the State Insurance commissioner.
This is something your attorney can look into if you are not up to doing this. It can be a stressful process.
The Office of the State Attorney General sometimes has a healthcare ombudsmen's office. I know people have gotten help with health insurance benefits this way, as well. I do not know about cases of workers comp or disability obtaining help this way; however, a call to any of these offices will likely be helpful.
I don't have numbers for your area. You will find them under state and federal government listings for your area.
DejaVu