Can an insurance company make me liable for paying a medical bill if I used my husband’s insurance instead of mine?
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Can an insurance company make me liable for paying a medical bill if I used my husband’s insurance instead of mine?
I am a secondary on my husband’s medical insurance and he is secondary on mine. It happened so the office of the provider of medical services suggested by my husband’s insurance was located more conveniently than the office suggested by my insurance. After the procedure and follow-up visits his insurance denied the claim stating that I should’ve used my own insurance in a first place. They don’t take into consideration my inconvenience if I had done so. Funny thing is that both policies are held at Blue Cross Blue Shield. We both pay union dues on time. I’m a member of Local 6 and his is 32BJ.
Asked on June 1, 2011 under Insurance Law, New York
Answers:
SJZ, Member, New York Bar / FreeAdvice Contributing Attorney
Answered 13 years ago | Contributor
It would appear that you could be liable for paying this bill. First, when insurance is secondary for you, that means that it kicks in when the primary insurance doesn't cover or is depleted. If the primary insurance is available for you, you don't have a right to choose to use the secondary insurance.
Second, inconvenience, as I'm sure you can imagine, is irrelevant to insurance companies; you are expected to use providers who accept your insurance.
If the amount is large enough to justify a lawyers fees, then you should consult with an attorney; you may have some grounds, based on the exact circumstances of your situation and the language of your policies, to fight this. If the amount is not large enough to justify going to an attorney, while there's no harm in using the internal appeals process of the insurer (and/or seeking help from your union), at the end of the day, it may be best to pay.
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