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RE: [IP] My appeal letter to BC/BS of Michigan (kinda long)



One other approach for dealing with $*#@()$#@ insurance companies (and I
used this against Blue Cross in NJ on behalf of a deaf child who was denied
surgery) is that if you have a state insurance commissioners office, that
you file a petition to have their license to sell insurance revoked due to
their bad faith refusal to meet their contractual obligations.  Insurance
companies in states with active commissioners offices really sit up and take
notice when their ability to operate in the entire state is threatened.  Of
course, this is a lot more work than filing a small claims court case.

Sheri


-----Original Message-----
From: Michael [mailto:email @ redacted]
Sent: Monday, November 05, 2001 8:51 AM
To: email @ redacted
Subject: Re: [IP] My appeal letter to BC/BS of Michigan (kinda long)


> I've written my letter that I will submit to BC/BS of Michigan to
> appeal their payment for only 200 test strips rather than the 300
> strips my endo and I think I should have each month. I think I've
> covered all the bases, but am open for any suggestions. Thanks!
> 

The insurance company is trying to get you to play their game. Ignore 
their comments about 200 strip limits. Make them show you where is 
says in YOUR CONTRACT OF INSURANCE, where there is a limit on 
payments for diabetes supplies. You have a contract with them which 
you had no part in negotiating. The courts will intrepret it very 
strictly in your favor under those circumstances. If you read it you 
will find very specific appeals requirements, however those take 30 - 
60 days at the most. After that time, you are contractually free to 
take whatever action you wish (at least under most contracts in most 
states). File a small claims action and make a press release about 
your crummy treatment at the hands of the GIANT insurance company to 
whom you pay outrageous premiums. Call the company's corporate office 
and ask for the name and address of the "Agent for Service of 
Process" you will need that and they are obligated to give it to you.

Michael
email @ redacted
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