What to do when both private health insurer and worker's comp deny claim?
Question Details:I fell at work and was told I need surgery. My Dr. failed to file the workers comp paperwork in a timely manner and my claim was denied. I have health insurance but the insurance company denied my claim on the grounds that it should have been filed with workers comp. I live in Nevada, am a teacher and am insured through the Teachers Health Trust. Do I have any recourse?
Please talk to a lawyer about this, as soon as possible; you might still have time to appeal the denial of the workers compensation claim (or otherwise get the claim re-instated), but whatever possibility there might be will have a very short deadline.
Your health insurance, like every other health insurance policy I've ever heard of, specifically excludes injuries at work. There might be a very small chance that the policy specifically ties this to workers compensation, in which case you might be able to force coverage there, but I doubt a court would agree.
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