My insurance won't pay up!

My health insurance denied my claim almost totaling $5000. Insurance states
that I must submit a police report to them because of the subregation clause
on my plan. After going back & forth from my insurance company to my state police dept...Finally, My insurance talked to the corporal. Corporal told
my insurance that I can not obtain a police report without a subpoena from
the court since it is investigative. So now I have to hire a lawyer to get a subpoena for the police report...Does this seem right? Is it really this difficult?

The report wouldn't state much. The injury was a simple assault by unknown
persons. Which makes no sense. If the persons are unknown then why does the subregation clause matter? They can't pay for any of the med bills if I don't know who they are.

You can give your repoert and get a police report number and that should suffice--if that is what you are asking?

Thank you for your reply.

However, I provided the police report # from the beginning. The insurance denied my claim.

The state police said that same thing to my insurance company. That the # should be enough. But they said that they need the actual police report. Which again, can not be obtained because it is a investigative report.

Should I hire a lawyer to subpoena the report?...OR...should I not have to. Does the insurance legally have to accept the police report #?

[msgny]

have them call the police perhaps...but yes it could be subpoenaed as well

something seems a bit odd here

Thanks again for a reply!

I have decided that I am going to contact a lawyer. I really believe that this insurance company plays the name blame game hoping that I will run around in circles, grow tired, & eventually give up. I am not going to give up though. This insurance company is crooked. I have been through so many claim denials & problems with them. So many employees in the company that I work for feel the same way. It is such a shame & so sad...insurance companies seems to get worse & worse for everyone (excluding teachers).

COVENTRY HEALTH IS GOING DOWN!!!! I WILL FIGHT THEM!!!

I recently won one claim fight...I will win this one too.

Let us know how it goes!!

Well, you hit it right on the nail. They are crooked. I worked for them and everything they did was to postpone payment. They would deny claims for "untiimely filing" when in reality, most were billed correctly.

I quit when I saw that they shred claims.

A very crooked company. I used to work for Blue Cross Anthem. To my knowledge these practices did not exist there.

Get a lawyer and sue them for emotional pain/distraught. I am sure that they are playing games from what I have seen.

Good Luck! Happy to be an ex-employee of Coventry!