ER Bill Nightmare: Denied for 'Misconduct'?!

my number one advice is to contact your State attorney general's office they handle things like this and they can be pretty quick about it and fight pretty hard for you and it will all be for free

So what happens when someone has a gran mal seizure and they attack someone but they would have known had they looked into their file first. Or syncope episode where you black out and have no control or know what’s going on due to heart is working to hard and not enough oxygen to the brain, i have literally lost it flipping out when nurse said something i found offensive which is “she isn’t vaccinated and because of that, she has to wait like everyone else, the EMTS explained (bc due to health) she can’t, it will kill her and currently she is barley going to make it she had hysterectomy week ago and this is the worst we have seen her and she refused and made me go to waiting room with 40 individuals coughing and having a extremely compromised immune system and chemotherapy, being unable to get treatment i stood up and said I’m not an addict, I’m very ill, do your F job before I drop dead because when I prove you wrong, you will never ignore the team who knows me

1st write letter and call and get human to give you definition and a reason "worded another way" if can't get it resolved easily. then call insurance company oversight government entity

Insurance company can’t decide on a whim to pay or not to pay a claim based on their opinion. What’s your policy say? That’s what’s important and legally binding.

But apparently prior to that, i recorded the state i was in and didn’t know i had done so which is how i knew i was blackout mold and if they made me wait any longer i would have been dead and my son who is my miracle child would have been with me but he was traveling in Europe with his father’s family but my sister called after i released the video and my threats - well sure that person was fired bc i was called back after 1/2 and i was in septic shock, Staph infection, 4 large abscesses and bacterial infection due to “later finding out i have black mold in my hvac system and behind walls, etc. so I guess I should come with A sign next time so i don’t get contempt for being sick and having to advocate for my self

they don't want to pay. period.

Contact the attorney general’s office and also contact the state Department of labor- that’s why we pay for insurance- BS - it’s called injured on the job you didn’t do it on purpose whether it’s an underlying condition your unaware of, which means you didn’t know- could have balance or vertigo, u could have many different things and not even know- so get the state involved- also they have A whistleblowers protection so in case u get fired for reporting them - better for you! Then u get your lawyers - you already have the attorney general’s office and dept of labor laws

Seriously need more information on his behavior. I've worked in a hospital and in health care for decades. That's an extreme case and only used for violent or disrespectful people. You didn't mention what happened to cause this action.

Kids do dumb things all the time and get hurt. Does that mean companies will now deny those claims? I climbed a step ladder too quickly, fell and dislocated my shoulder. I was careless, yes, but can they claim willful misconduct?

Yes, a bill can be denied for “willful misconduct” but it’s rare. This usually applies to workers’ comp (injury from fighting, intoxication or breaking rules) or VA/military care (self harm, illegal activity). Private insurance and Medicare typically use different wording. Ask for a denial letter and see if you can appeal.