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    giffordcofer's Avatar
    giffordcofer Posts: 1, Reputation: 1
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    #1

    Jun 18, 2012, 10:08 PM
    vision exam fraud
    Can I sue my vision insurance company for a payment to one of there provider even if the claim is not a valid claim. My policy indicate the my vision insurance does not pay on a medical exam, however, they paid one of there provider for a routine exam and it was classified as a medical exam, preventing me from seeing another eye provider.

    I have Contacted my vision insurance company and explained several time a false claim was filed, for a routine eye exam, but is being said I could not receive my contact lens prescription because a medical exam. However, the were paid for the exam and fitting I still have neither.
    AK lawyer's Avatar
    AK lawyer Posts: 12,592, Reputation: 977
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    #2

    Jun 19, 2012, 05:00 AM
    Explain, please, how you are not complicent in this fraud on the insurance company. They did a medical exam against your will? Or perhaps you agreed to the exam, expected to pay, but instead they made a claim to your insurer against your will?
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
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    #3

    Jun 19, 2012, 05:16 AM
    So you wrote a check and paid for the exam and did not tell them to submit it to insurance,

    They were paid twice ? Or who do you think was going to pay for the exam.

    If you go to the eye doctor to have your eyes tested, this is considered your visit. ( at least with any vision insurance I have had over 30 years.

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