PITTSBURGH – An estate representative and a Pittsburgh hospital allege an insurance company has unlawfully denied a late man's insurance claims.
Emily Zombek, as executrix of the estate of Thomas Kopp, and Allegheny General Hospital recently filed a complaint in the Allegheny County Court of Common Pleas against Golden Rule Insurance Co. alleging breach of contract, bad faith insurance practices and violation of the Unfair Trade Practices and Consumer Protection Law.
According to the complaint, Kopp purchased a health insurance policy through the defendant.
The suit states Kopp received care on May 21, 2017, through his primary care physician as well as on Sept. 6, 2017, for complaints of a severe sore throat and dry cough and was diagnosed with seasonal allergies. The suit states testing in October 2017 revealed he had esophageal cancer and he died in March 2018.
The suit states Kopp filed insurance claims with the defendant and was advised in February 2018 that the defendant was denying his claims because of a preexisting condition of esophageal cancer. The plaintiffs allege this is false because Kopp was only being treated for blood pressure and seasonal allergies until October 2017. The suit states the defendant has failed to rectify the error.
The plaintiffs allege Kopp's estate incurred $87,871.61 in unpaid medical expenses to Allegheny General Hospital.
The plaintiffs are seeking all reasonable sums due, attorney fees and court costs. They are represented by Sean P. Audley of Audley Law Offices PC in Pittsburgh.