Portland, OR asked in Insurance Bad Faith and Insurance Defense for Oregon

Q: Medical insurance company is trying to retroactively deny coverage. What are my rights?

My wife was recently laid off and had some medical and dental work done before her coverage ended. The insurance companies processed and paid the claims, but now one of the insurance companies has demanded payment back from the dentist. The dentist office has never seen anything like this before, and the benefits management company that handled the insurance for the employer stated coverage ended the week she was laid off. We've always had until the end of the month we paid for coverage. Is this legal? After harassing the benefit management company for two months, they just offered us COBRA. Will COBRA work retroactively?

1 Lawyer Answer
Tim Akpinar
Tim Akpinar
  • Insurance Claims Lawyer
  • Little Neck, NY

A: An Oregon attorney could advise best, but your question remains open for two weeks. COBRA does have retroactive features - this is something that an employment attorney could probably explain better than attorneys who work only with general medical insurance claims and denials. You could either repost your question under Employment Law, where an Oregon employment attorney might see it, or if your Human Resources group is on good terms with you and helpful, maybe they could help - seasoned HR managers are usually well-versed in the operation of COBRA. Try to move quickly, as there could be tight time windows in which to exercise your options. Good luck

Tim Akpinar

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