Complaint 10 of 12 in “Errors in Claim Payments”
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- Insurance Carrier: Humana HMO
- State: IL
In 2002 my wife donated me a kidney. The operation took place at the University of Wisconsin Hospital. I had full insurance and the required referrals. Now I am being sued because the hosptial has stated that the day after my operation my referral ran out, even though my doctor at that time renewed referrals for my monthly up-dates for my transplants.
I have contacted the insurance company, the Illinois Department of Insurance, and my former Doctor. No one has been able to help me with this and now I have been sued and must now pay off a $18,000 medical bill that I had full insurance to cover. How could the insurance company refuse to pay a person’s claim the day after they are recovering from a major operation. I work for the state of Illinois I have always had insurance coverage.
Insurance Expert Answer:
You may want to speak with a lawyer in your area. If the hospital's claim dates from 2002, that's over 6 years ago. In most states the statute of limitations (SOL) runs out in 6 years or less, so unless it sued you before the SOL ran out, the hospital would be out of luck although I do not know IL law or what its SOL is in contract claims. Also, if there was an error made by your insurance company in 2002, the same 6 years (if that is the SOL) likely prevents you from suing it.