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Please help - Had appointment with doctor before plan benefit changed from $0 co-payment to $500 co-payment. Doctor request surgery approval on May 8, 2005. Insurance company delay approval till May 26, 2005. Doctor had no more spaces for surgery on May so surgery was perform on June 17, 2005. After benefit changed (starting June 1, 2005). Should I sue in small claim the Insurance for the $500.00 co-payment? Do I have a case? Thank you - Thank you.
Lennie ![]() |
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The delay was only eighteen days. Subtract the weekends and you probably have something like 14 or 15 days. You will first need to find out is 14 days is a reasonable time to approve surgery. If it is then you do not have a case.
If you come to find out that they must approve surgery say in 2 days then sue. I doubt this is the case though. |
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Thank you for your help - I Called the insurance company and was informed that for surgery approval usually takes 24h for Emergency surgery and 2 days for Non-Emergency, so looks like a have a good case. Will file paper with small claim court on monday, thank you very much.
Lennie ![]() |
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