Wednesday, March 22, 2017

Private Shield plan - 5 month delay in settling a claim

A consumer asked for my help.
She is covered under a Private Shield Plan. She suffered some pain in the joint. She went to the general practitioner who tried to treat the pain, but the treatment did not work. The doctor referred her to see a specialist.
She went to the specialist and was hospitalized for observation for two days. The specialist carried out several tests to identify the source of the problem. After discharge, the patient paid a bill of almost $8,000.
She submitted her claim to the insurance company for reimbursement of the hospital bill. The claim was not settled for five months

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