Va Insurance Fraud For Service Connected Claims

[Troy Spurlock]

I live in Oregon, and as some of you may have read a month or two back, brought to the attention of this forum how the VA has billed my private insurance over $6000 in claims it was not entitled to.

Yesterday a co-worker told me he too has had his insurance billed for service-connected conditions.

We intend to draft a collaborative letter to our respective Congressmen and women and CC all veteran organizations.

If you live in Oregon or anywhere else and have been victimized by the VA with your private insurance being billed for service-connected disabilities, I wanted to hear from you; that is, if you are willing to sign onto our letter to be distributed to Congress and Veterans' organizations.

Thank you,

Troy Spurlock

spurlockt05@gmail.com

gulfwar_veteran@frontier.com

[MikeR]

I don't know if this is done on purpose or if this is more incompetence? I definitely would get a congressional rep involved if I had attempted to get this corrected and could not. If anything the insurance company should not pay the claim either and have their attorneys jump all over this.

[john999]

It happens all the time. My insurance company wants me to send them proof they are being charged for SC conditions. They should be investigating and not waiting on me. I told them to pay nothing since it is all for SC conditions.

[carlie]

I wonder how many insurance carrier's are being billed

contrary to VA regs.

Yes, VA is not supposed to bill our insurance carriers for any

condition that has been adjudicated to be service connected.

BUT

If a vet is being compensated at the 100 percent level due to IU,

and the vet has medical insurance - then VA will bill the insurance

carrier's for any and all conditions that have not been adjudicated as SC'd.

I believe the key answer for VA to legally bill insurance carrier's lays in -

"if you are receiving care for a non-service-connected disability and have health insurance".

https://iris.va.gov/scripts/iris.cfg/php.exe/enduser/std_adp.php?p_sid=pOybV*7j&p_lva=&p_faqid=40&p_created=1033509197&p_sp=cF9zcmNoPTEmcF9ncmlkc29ydD0mcF9yb3dfY250PTQ0JnBfc2VhcmNoX3RleHQ9aW5zdXJhbmNlJnBfc2VhcmNoX3R5cGU9NiZwX3Byb2RfbHZsMT1_YW55fiZwX3Byb2RfbHZsMj1_YW55fiZwX3BhZ2U9MQ**&p_li=

Inquiry Will you bill my health insurance carrier? Answer The law requires VA to bill insurance carriers for covered veterans. Some veterans may have health insurance coverage under a spouse's policy. If you are receiving care for a non-service-connected disability and have health insurance, your insurance carrier will be billed. VA does not bill your health insurance carrier for VA-adjudicated service-connected disabilities. (An adjudicated service-connected disability is one for which you have filed a claim and VA has determined that you are service-connected)

[carlie]

This is a repeat and run on of a topic that was closed in August 2010.

If you would like to contact Troy on this issue his email, etc... addresses are shown below.

I am closing this thread.

carlie