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Insurance power over time Colorado

Discussion in 'Health Insurance, HMO, HIPAA & Disability' started by Brad66chevelle, Feb 3, 2017.

  1. Brad66chevelle

    Brad66chevelle Law Topic Starter New Member

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    I have a simple question and hopefully I'm on the right Forum area for it. I recently got surgery and had to fight my insurance company to approve it due to tobacco use. I have quit the tobacco but my doctor said something that made me wonder. The doctor said that I had better stay off any form of tobacco for about 2 years since the insurance company can go back and test me and then go after me for the money on the surgery. I have never heard of such a thing and I figure if the insurance company has already approved it and paid for it that they couldn't retroactively come after me. Can anyone help me out here whether or not they can do this and where do I stand with the law. Thanks again for everyone's help.

    Brad66ch
     
  2. army judge

    army judge Super Moderator

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    Hard to say, but I'd simply avoid tobacco to avoid additional legal entanglements.

    Or, you could use tobacco and see if what you were told is really true.

    Your life, your rules, right?
     
  3. hrforme

    hrforme Active Member

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    Did you happen to claim you were a no smoker on you original or any later insurance applications or paperwork? If so, you were possibly rated at a lower premium which could be considered fraud if you actually are a smoker...
     
  4. Brad66chevelle

    Brad66chevelle Law Topic Starter New Member

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    Thank you for your reply. I don't plan on using tobacco as I had to quit to get the surgery. I'm just questioning whether they have the right to retroactively go after me.


     
  5. cbg

    cbg Super Moderator

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    If they based your premium on a false premise (I'm trying not to say, if you lied on your application) then yes, they have the right to retroactively "go after you".
     
  6. adjusterjack

    adjusterjack Super Moderator

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    Your doctor doesn't sell insurance and your insurance agent doesn't perform surgery.

    There is only one place you are going to get the answer to that question.

    Look in your policy or plan booklet (contract) that explains your rights and obligations of both you and the insurance company.
     
    army judge likes this.
  7. army judge

    army judge Super Moderator

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    Unless a physician is both a licensed physician and insurance agent.

    I'm certain there are people who hold both credentials these days. LOL
     
  8. adjusterjack

    adjusterjack Super Moderator

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    Now that I think of it, I can envision scenarios where that might happen.
     
  9. army judge

    army judge Super Moderator

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    Today, it seems, people are full of surprises.
     

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