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Question:

PLEASE HELP regarding preexisting condition During my process of searching visitors insurance for my parents and little brother who visited in May'08, I was very much impressed with your website and particularly your considerate posts and I bought a very comprehensive insurance policy for the second time. Even in Sept'07, I had bought the same insurance for my family. Unfortunately, this year in May when my parents and 11 year old brother arrived, my brother fell sick with Hepatitis A (Jaundice) and I had to urgently rush him to the hospital after precertifying via the insurance company. Since then I have got loads of medical bills everyday and the letter from insurance saying that the disease was preexisting. I have tried to reach insurance company several times and every time I talk with a customer service rep who has no proper knowledge of the case and I am unable to explain to them that the disease was not preexisting. They do not even have a dedicated customer service rep I can talk to. The doctor has supported my claim that the disease was not preexisting and has sent the notice indicating the same to the insurance company. Also the pediatrician in India has declared that my brother was fine when he left India. I had bought Patriot America from 11 May08 " 10 July08 and insurance is not paying a single dollar. Can you please help me Can I call you and talk about this Ever since then, I have been so much troubled by all the insurance bills and the very fact that I am so much helpless to defend my position. Please help me out.

Answer:

Hello, We had a phone call conversation about this around an half an hour back. As I described to you, I currently have no access to any of the claims data than what you described to me over the phone. From what you described, your brother had Hepatitis A just few days after coming to the US. I recommend that you read https://en.wikipedia.org/wiki/Hepatitis_A It describes that Hepatitis A is caused by contaminated foor or water in developing countries like India and something not that common in the US. It seems that your brother had got infected in India itself and the symptoms got developed right after coming to the US. Therefore, it would still be considered as pre-existing conditions. It is not just the conditions that were previously already known but the ones that existed are pre-existing conditions. e.g., 1. if you come to the US and 2 days later, you realize that you had malaria. It might very well be pre-existing condition as malaria is not common in USA but in India. You had been infected with mosquito bite in India just before coming to the US. 2. One week after coming to the US, you discover that you had diabetes (many people go to free check ups held at temples, for example). Diabetes didn't happen in one week, you just discovered about it. 3. You got infected with HIV 4 years ago, but AIDS symptoms just start showing after 2 weeks after coming to the US. It is still pre-existing conditions. As you can see, depending upon the disease, the symptoms appreance duration may vary. As we discussed over the phone, if your doctor is able to write any letters or provide any other kind of evidence otherwise, I can help you use that as the appeal after your father gives me the authorization to discuss with the claims department of the insurance company. I will ensure that I will help you with to the best of my abilities. Meanwhile, if you have any questions, please feel free to contact us at any time or post here.

I had posted the thread before I talked with you and will follow your advice. I will send you the authorization letter from my father and other letters soon. I will sincerely appreciate any help you can provide in this regard. I have been really tensed ever since the whole issue has started and despite buying all the insurances, I am facing this trouble. Thanks Pragya


You are welcome. I am glad to help in any way I can.

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