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  1. #1
    Join Date
    Nov 2009
    Posts
    1

    Default When Promised Primary Insurance Payments Are Delayed

    My question involves insurance law for the state of:IL
    After Medicare, I have a primary insurer that is managing the state provided retired health benefits which doesn't release funds to the care providers until the state retirement system releases funds to it. This has meant an ever increasing delay since funding is paygo. there are budget shortfalls in the state; and the delays are now almost a year in practice when the state claims a delay of only 112 days. My secondary provider is the Federal Gov't. I don't pay premiums to maintain either policy. The primary insurance sends me statements for the services stating the benefits are paid, and I owe nothing, when in actuality they have not released the funds, because they have not been funded by the state, as it is first-in / first-out as-far-as-the-money-goes system. This means I have care providers wanting payment, and I have a secondary insurer just standing idle. At some point can we say the primary insurer has vacated its responsibility, and the secondary insurer can be activated? Thanks, John

  2. #2
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: When Promised Primary Insurance Payments Are Delayed

    The secondary insurer is not going to pay a cent it's not obligated to pay under contract, even if you attempt to unilaterally declare a default by the primary insurer.

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