Question
What is the name of your state? California
I got hurt playing football last October when I was 17. I'm now 18. Earlier in the year, my parents and I bought special "Football Only" Insurance from the school. When I got hurt we gave them the football only insurance card and they said it was OK. After we filed the School Claim Form and did everything they wanted us to do. They said they wouldnt pay and expect my Mom's medical insurance to pay. We think they should pay because it happened while I was playing football, like the insurance we bought stated for. The bills are upwards of $3000.00 and they dont want to pay for our claim. Is there anything legally we can do to make them pay?
Answer
Make WHO pay?
Go back to your English teacher and ask for a lesson on pronouns.
Answer
Make the Football Insurance Company pay. Thank you
Answer
What is the reason they gave you for declining it?
All insurance policies have limits. IF your particular type of injury is listed on the football policy as an exclusion, they have no obligation to pay it.
So what did they give as the reason they were declining?
Answer
sorry, i have been away for a long time. The reason they gave for not paying is because we had other insurance with my mom's work so they assumed my mom's work insurance would pay it, but the activity took place DURING a football game
Answer
Just follow the policy's appeal process. If that doesn't work, you may be able to appeal to your state's regulatory agency. That should all be outlined in your insurance policy.
Answer
Many of these plans are supplemental or gap coverage and not designed to be the primary source of coverage. Benefits payable when other coverage is in place is usually minimal. The typical procedure is to file with the major medical carrier (if one is present) simultaneously with the scholastic accident plan. Sometimes the SA plan will pay a nominal amount, usually $100 or so, then wait on the other carrier to pay. The unpaid balance will be coordinated with the SA policy limits.