Hilary
Murray,#2Consumer Comment
Wed, November 22, 2006
I work for a health insurance company, and I call other health insurance companites every day. Every single one I have ever called says something on the lines of "quotation of benefits does not guarantee payment." Yes, you were mis-quoted, and your insurance company might have some kind of appeals/exception process, but it is still YOUR responsibility to be aware of your benefits. "Nobody told me" is NOT a valid excuse. Your health insurance company is required by federal law to send you notification if you are in a pre-existing waiting period. If you were in that period, why would you even think that something pre-existing would be covered??? If you had a year's worth of previous coverage and less than a 63 day break, you can send your new company a Certificate of Creditable Coverage from your old insurance company. That may waive some or all of your PEC period. If it is waived, any claims that were denied as pre-existing would have to be reprocessed.
Sue
USA,#3Consumer Suggestion
Sat, November 11, 2006
You are in luck as I know NJ has very strict insurance guidelines that companies and agents MUST adhere to. Call the NJ Dept. of Insurance and find out if this company is even licensed to sell in NJ and also see if the agent is licensed. If it is and he is, file a complaint with the NJ dept. of insurance. If it's not call the NJ attorney general's office and speak to someone in consumer protection and file a complaint. Also call the BBB and Consumer affairs and both have online complaint forms. The agent misrepresented this policy to you and that is serious offence under NJ insurance laws. Best of luck!