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Copay Violations

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Consumers expect to pay a copay when they go to see their doctor or visit the hospital.  They rely upon their health insurance company to tell them how much is the copay for any health care service and when to pay such copay.  Often it is the insurance company that interprets the regulations and laws that are applicable.  Missouri has a limit on the amount of copays and coinsurance that some insurance companies can charge.  Recently we have noticed that not all insurance companies are following the law.  For example, Missouri has a copay law that prohibits an HMO in the State of Missouri from charging both a copay and coinsurance for the same health care service.  Currently we are representing a class of people who were charged both.  We are seeking an order from the court requiring the defendant to refund the excess copay/coinsurance charge.  If successful, we may be able to restore approximately 8 million dollars to citizens who paid this excess charge from 1998 to 2010.

Additionally, there are many other insurance regulations to protect Missouri’s citizens.  We have noticed that not all companies adhere to these regulations which cost the citizens of the State of Missouri significant monetary damage.  If you believe that your copays, coinsurance and/or deductibles are higher than what is legally allowed please don’t hesitate to contact us.  You will be able to talk with an attorney who can listen to you situation and determine if you are paying too much.

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