KANNAPOLIS, N.C. — An Action 9 investigation exposed something you may not know about your health insurance company.
Joy Haynes said she was at a restaurant when a server spilled a hot beverage on her, burning her. She went to urgent care to get treated and said it cost her about $300, which she paid for out of pocket.
Haynes told Action 9′s Jason Stoogenke that the restaurant’s insurance took responsibility and reimbursed her for the trip to urgent care. It also had her sign a form agreeing that she would not try to get more money from the company later. Haynes said she didn’t have a problem with the agreement, so she signed the form.
State Health Plan said it spent $600 on her visit to urgent care and that the restaurant’s insurance should have reimbursed the company, but since Haynes signed the settlement form, she was now responsible for paying $600.
[ Action 9: Wedding videographer didn’t deliver, couples say ]
Haynes told Stoogenke that she forgot about the incident until more than two years later when she received a letter from her health insurance company, the State Health Plan.
“Last thing on my mind was having an additional $600 to have to pay for something that happened two years ago,” she told Stoogenke. “I didn’t realize that it was my responsibility to take care of their issue as well, making sure that they got paid for services that they rendered to me.”
Blue Cross and Blue Shield, which runs the State Health Plan, told Stoogenke it pursues people in cases like this to keep healthcare costs down. Other insurers have similar practices.
Haynes said she reached out to the restaurant’s insurance company and that after all this time, it still agreed to reimburse her health insurance company so she wouldn’t have to.
Stoogenke said it’s important to know your insurance policy. If the other party’s insurance is reimbursing you for your medical bills, make sure it reimburses your health insurance company too. Do not sign a settlement or anything stating that it concludes your business with the other insurance company until you know your health insurer is satisfied.
If you do get stuck with the bill, it’s worth getting back in touch with the responsible party’s insurance company to see if it will still reimburse your health insurance company.
(WATCH VIDEO: Action 9: Watch out for “unclaimed rewards” scam)
This browser does not support the video element.