My question involves insurance law for the state of: Florida
My insurance provider seems to have found an interesting way to deny my claim and I am hoping one of the experts here could shed some light on how this can be possible. In short, I had a 6 month gap in insurance prior to my new policy with the denying insurer. Pre-existing clause is in effect due to the gap in coverage. 3 months into my policy I start having a persistent neck pain. I go to the doctor and get an MRI of the neck. Dr. says I need surgery and we schedule it. 3 days before the surgery the doctors office calls and says that my insurance company will not authorize the procedure because it could be a pre-existing condition. They refuse to determine if it is in fact pre-existing until AFTER the surgery. The surgery costs close to $30,000 so there is no way I can afford to get the surgery done with the hope that it might get approved afterwards. The insurance company states that they are not denying the claim. I sent them all of my medical records and they refuse to determine if the condition is pre-existing.
What do you think?