Why can my insurance company ask if I other insurance?

Question

Every year my insurance company denies my claims until I send them a form telling them I don't have any other coverage. Why can they do this? Is there an agency I can file complaint with to try and stop this practice? This seems to me that it is equal to invasion of privacy, if the claim is legitimate why don't they just pay it?

Answer 1

Does your employer not have a middleman (insurance agent) between them and the insurance company?  We do so we go to the insurance agent for some issues.  Check also the website of your insurance then click on your coverage details.

This site would be a valuable reference for insurance:

www.surelyinsured.com

Answer 2

Many people are covered by multiple carriers, via their parents, or spouses employment, or even attendance at a college. This is a legitimate business practice. You don't get to decide which carrier is primary. State law usually does. See link below.

Don

http://mtnhealthinsurance.com

Answer 3

Insurance companies are require to at most pay you what you have spent or cover what your bills are.  They will not pay you a dime more.  I actually have multiple policies with my wife employers and mine.  We use both but they have to coordinate.  We wont make money but we dont have out of pocket either.   This works well for us.  This is probably why that ask to see if there have been any changes insurance for you.

Answer 4

They need to know that they are your primary insurance and that another insurance shouldn't be covering your claim.  Hope this Helps.

Answer 5

subrogation/gives you a better rate/they share on claims

Answer 6

They want to make sure that you have no other coverage that should be paying a portion of the claim.

Answer 7

You gave them the right to invade your privacy, when you signed up with them.

You can complain to your state insurance commissioner, but I don't think it's going to stop.

Answer 8

It is a legitimate question.  Sorry you don't like it.

Answer 9

It is annoying.

Insurance companies want to pay as little as possible. If you have another insurance company (say you have insurance through your wife's company and yours), they want to find out so they can make you use the other company as primary if possible. Primary company would pay most, secondary leftover amounts, and sometimes tertiary insurance if the first two don't cover some things.

Most larger companies will let you call over the phone and tell them, but the little irritating companies want you to mail it in with your signature so they can deny claims longer. I have known these companies to have these forms on their desk, and still deny claims. Little companies are cheap, but claim processing and paying is usually very low priority.

Answer 10

Your insurance company has the right to ask if you have other insurance, because of the Coordination of Benefits clause.

When you signed up for your policy, you agreed to provide them with the information.  That's the way it works.  Its not an invasion of privacy - you are obligated to provide the information to your insurer, otherwise they have no legal obligation to pay your claims.

(Additionally, if you have other insurance and don't tell your insurer, they can go back and revoke all of your past claim payments that would have been affected.  They'll only repay the claims after the Coordination of Benefits has been straightened out.  So, if you have other insurance, its best to report it now, rather than deal with a mess of paperwork years down the road.)

Answer 11

You can't have duel health insurance. Duel dental is okay but health and vision you can only have one health insurance. They can deny the claim if another company is picking up the tab.

Answer 12

Yes, insurance companies have right to ask if you have other coverage. If you have two major medical policies, they have to coordinate benefits, so yo won't make a profit on your claim. As long as you hold out information, and don't respond, they will hold the claim payment. There is nothing you can do about it.

If you have a major medical, and a hospital indemnity policy, you don't have to tell them about the indemnity policy, because it pays directly to you, and not the provider, unless you assign the benefits to the provider.

An example of a hospital indemnity policy would be a policy that pays so much per day on the hospital room, such $100, $200, or $300 per day when hospitalized.

Another example would be a policy which paid your deductible and copays. Let's say your deductible is $500, and the copay is 80/20. So, your share of the bill would be the $500 deductible, plus 20% of the bill up to certain cap. Not many companies write these types of policies.

Another example would be a cancer expense policy. If you are being treated for cancer, your major medical policy will cover the treatments, minus the deductible and your copay amount. You don't have to tell them about the cancer expense policy, because it pays directly to you, unless you assign the benefits to the provider.

When you fill out the paperwork for treatment, it will ask about your insurance. Any indemnity policy which pays directly to you, you do not have to put that on the form. If you do, you are assigning the benefit to that treatment facility, and the benefits will go directly to them, instead of yourself.

Hope this answers your question.