Can my Health Insurer ask for money back after they already said they would cover something and paid me? Â

Can my Health Insurer ask for money back after they already said they would cover something and paid me?  

answers 0:After calling them 3 times and making sure the work was covered my dental plan now says THEY maid a mistake and wont cover anything at all. They had already paid one bill and now refuse to pay the second. On top of that they are asking for the money they paid on the first bill back. They then proceeded to tell me that I should of received a notice of my plan mistake on April 30th. I had the work done on March 21st. Is this legal? I went from a 200 dollar bill to a 1200 dollar bill in a second....Show moreanswers 1:If you called customer service call center the calls should have been taped. if the rep verified the incorrect benefits then the company has to pay the bills as a one time exception. Since there was no w! ay for you to know of the plan mistake the company should still cover the services. A call to your state insurance commissioner will get this resolved quickly.answers 2:Sounds like the law would be on your side if they cannot prove that the change of policy fell before your treatment. In that case, they might have a chance of getting their money. Either way, I would not pay. I would actually contact the Insurance Commissioner of your state and report them as well as get the right answer.answers 3:Medicare is virtually broke because it really is. Seniors are literally not one hundred% lined now and performance to purchase supplemental coverage to conceal the gaps left through Medicare. those human beings have paid into the Medicare equipment for most of their man or woman lives to have some coverage of their "golden" years, so including extra human beings will merely insure that it is going broke quicker and insure that the human beings already on it will be left without cov! erage. So no, i don't think of including extra those which hav! e not qualified for this particular application is a superior element....answers 4:Well, have you looked at your coverage details? I would look at the policy coverage details, to see if ultimately, you think that coverage is there, or isn't there. If you agree coverage isn't there, you can't do much about the second bill, HOWEVER, I'd write a complaint letter to your state insurance commissioner, outlining that they TOLD you it would be covered, they PAID the bill, and now they're changing their minds. It's ILLEGAL to make coverage changes DURING the policy year; so if that's what they're hanging their hats on, they can't do that. Regardless, a letter to the insurance commissioner should fix at least the first bill. If you disagree wiht the coverage terms as your policy spells them out, and think they are unfairly denying the second bill, send a copy of the relevant section with the letter of complaint, to the same insurance commissioner. They should write a letter re! questing an explanation from the carrier, and cc you in on it - and you should get a prompt response (within 30 days)....answers 5:If the service wasn't covered you don't have any right to the money. But file a complaint with you state insurance department for your own protection. If you truly weren't supposed to be paid, they can go after you in court.If the life insurance company paid your death benefit by mistake, would you feel justified in keeping that?...