1/14/2006 - Posted by:
McCraney Montagnet & Quin PLLC
Phone: 601.707.5725
Fax: 601.510.2939
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Wrongful Denial of Health Insurance Claim; $6050 settlement of $3100 insurance claim

The parents of a young boy who was treated for several illnesses, including Attention Deficit Hyperactivity Disorder, Reading Disorder, Oppositional Defiant Disorder; Sensory Intergration Dysfunction and Fetal Alcohol Syndrome, made a $3,100 claim for health insurance benefits pursuant to an individual health insurance policy they had purchased from Blue Cross & Blue Shield of Mississippi (BC/BS).  BC/BS denied the claims as pre-existing conditions, claiming that the boy had been treated for Attention Deficit Disorder within a year of the effective date of the policy.

The parents sued BC/BS, claiming the boy had not received treatment for the listed illnesses prior to the policy period because none of the illnesses had yet been diagnosed, nor were they diagnosable. 

BC/BS settled the claim for $6050 - an amount which almost doubled the outstanding medical bills.

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