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Allstate Denies Critical Care Insurance Policy Claim for Being Five Hours Too Early

On Dec. 31, 2010, at 7 p.m., Chris Nygren was having chest pains. He was taken to the hospital where he had heart surgery that saved his life, according to an article published by CBS San Francisco.

Luckily, Nygren got there in time. His primary insurer paid for most of his $167,000 hospital bill. This left him with only a few thousand extra dollars he needed to pay for his hospital care. He felt sure the $10,000 supplemental Critical Care Insurance Policy he’d recently purchased from Allstate would cover the remaining expenses, according to the article.

Unfortunately, Nygren was not as lucky with his Allstate critical care insurance. Allstate decided he had arrived at the hospital too soon.  Apparently, he arrived five hours before his critical care insurance became effective.  As a result, Allstate processed his claim under the insurance exclusion for pre-existing conditions, and denied his claim.

“It’s hard not to feel like you’re the David and they’re the Goliath,” he told CBS’ San Francisco Channel 5.

At that point Nygren called 5′s Consumer Watch. The program’s producer contacted Allstate and within less than two weeks Allstate agreed to pay the claim. According to Channel 5, Allstate said it was determined to do the right thing as soon as they were made aware of Nygren’s case.

Source: CBS San Francisco

If you feel that you were wrongfully denied critical care insurance benefits, contact Grabhorn Law.