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; approximately $9000 in unpaid claims; $19,800 settlement

Prior to policy period, Plaintiffs' son fell and injured his knee while playing at school.  Plaintiffs later obtained an individual health insurance policy with Blue Cross & Blue Shield of Mississippi (BC/BS).  After the effective date of the policy, Plaintiffs' son begins to complain of pain, which is ultimately diagnosed after extensive testing to be related to a congenital condition in the boy's hip.  BC/BS denied claims for payment associated with the hip condition on the basis of the Company's pre-existing condition exclusion, claiming that he had received treatment for it when he went to the doctor for his injured knee.

BC/BS settled shortly after filing suit for $19,800 - an amount which exceed twice the amount of unpaid claims.

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