by rominyou » Fri Jul 30, 2010 11:00 pm
the health insurance refusing to pay the trasportation to children's hospital stating that it is hospitals responsibility because they felt the need to send my child to children's hospital in sacramento. Due to this and another similar case where a hospital bill gets bounced between our medical ins. and mental ins. -because my son's hospitalization started with meical problems and ended in psychatric diagnosis-my credit score has dropped a lot. I want to send a demand and take them to small claims court claiming damages.
Posted: Sat Jul 31, 2010 12:46 am Post Subject:
I want to send a demand and take them to small claims court claiming damages.
okPosted: Sat Jul 31, 2010 03:11 am Post Subject:
That's a post for a legal forum not an insurance forum. There are no where near enough details here for an insurance professional to develop much of an opinion and give you guidance, nor is there enough information for an attorney to develop much of an opinion and give you legal guidance.
Posted: Sat Jul 31, 2010 03:14 pm Post Subject:
Reimbursement for out of pocket expenses are usually defined by the words "medical necessity" or "medically necessary". Transportation that is "medically necessary" typically involves an ambulance ride because it is unsafe, unwise, or impossible to transport a person in a private passenger automobile.
If a patient is being transferred from one hospital to another because the second hospital offers specialized care required by the individual, the insurance company may not see that as medically necessary, but rather a convenience. Pressing the point vigorously may change their interpretation, but don't count on it.
Some policies may provide for the transportation expense of a parent to visit a hospitalized child or dependent, or to transport that person to a distant hospital if no local services are available. But these are the exception, not the rule.
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