Medical Insurance Trying To Bill Homeowners Insurance Policy

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WhatInThe

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A health care insurance company is using a contractor to challenge a hospital bill for a ER visit/one night stay. The patient had an accident at home and is now getting letters implying a third party, not the patient should pay for the bill. The only other third party is the home owner's insurance policy. The patient is wordy and inarticulate at times and I think the narrative is an accident from negligence. It was/is a common problem for seniors but at their home.

I've heard of contractors or consultants reviewing bills but never directing their efforts directly at the patient's homeowners policy, I've heard of auto insurance being billed but not homeowners for household incidents. What's next home owners paying claims for someone cutting themselves with a kitchen knife? They're also questioning a battery of tests(per doctors) which could be nothing but coding errors but that's not the direction the company and letters are heading.

Has anyone received a letter from a third party consultant implying or telling the patient they need to pay more or all of the bill on seemingly routine procedures and insurance claims?
 

Here's something.

As a home owner, you are liable for many of the injuries a visitor can incur in your home. In the event that an invited guest or unexpected visitor should be injured in your home through no fault of their own, your homeowners insurance would likely pay medical expenses and damages. It could even pay for lost wages if the injury resulted in the person being out of work.

When it comes to injuries, your homeowners insurance only covers your liability as a property owner. So if you or one of your family members is injured at home, it would be your medical insurance rather than your homeowners insurance that would pay for those injuries.

http://www.salzberginsurance.com/bl...eowners-insurance-cover-my-medical-bills.aspx
Click to expand...

Reading the homeowner's policy should also answer that question, I would think.
 
This is THE owner. And if what if a home owner did not have owner's insurance for what ever reason should they be denied medical care coverage they paid for? It's medical insurance for medical procedures regardless of cause, where, when etc. The medical insurance should fully disclose and spell out policy like that. Insurances should not be intertwined or dependent on each other.

This stay or claim in the hospital has other issues as well. Several procedures were denied as being duplicate or unverifiable but the letter have come all year. A third party claiming to be the hospital itself is sending robo collection calls. They went to the hospital billing department and they don't have information on the calls or those outstanding balances/reference numbers. The letters appear to be pressuring the patient just pay it and be done with it. It's simply too much and become even more frustrating since the patient has paid into insurance, medicare, medicaid for decades which makes them question the system.
 

You should probably seek legal advice. This is a totally different scenario from what you first posted.
 
There is such a thing as subrogation where the ins co tries to find somebody to pay the bills instead of the ins co. Usually its the result of an accident of some kind. Ive run into it twice and it gets really nasty. First time I had my dogs out on conservation land loose, was watching the dogs, tripped over a tree root and landed on my knee. Limped home but had to have knee xrayed. Nothing broken just barely bruised. Small amt of money involved. Didnt think anything of it and then started to receive phone call from a subrogation co that my health ins had turned the claim over to. Questions like whose dogs were they, whose land was it, what were you watching etc etc. on and on for months. Finally i asked if they wanted me to pay with the dog’s biscuits. Would that make them happy?. Then finally shut up and paid the bill. Had the same thing happen with another fall I took off my horse. Same crap, different day. I finally asked if they wanted the horses carrotts. Would that make them happy. They shut up and paid. If its subrogration and it involves a large amt of money you may need to contact a lawyer to take the ins co to task.
 
Unless things have changed drastically with homeowners insurance providers
I was always told they do not cover any claims by a person who lives there.
 
A person's Personal Homeowner's insurance policy would not pay for medical costs for the named insured. You cannot be liable to yourself. The liability coverage is for others, persons who are injured at your home or property due to your negligence- hole in the lawn, slippery rugs, icy walkways, etc.; up to the policy limits.

Insurance co's do have a right to subrogate from a responsible party. I never heard of health insurance trying to subro against Homeowner's coverage. But then, I didn't work in subro.
 
Williepaws said:
There is such a thing as subrogation where the ins co tries to find somebody to pay the bills instead of the ins co. Usually its the result of an accident of some kind.
Click to expand...


Most of the time the health insurance policy will pay up front...
then try to recoup their payment IF there is third party liability/payment.
 

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