Celtic Insurance sued by woman over un-reimbursed medical costs

Kelly Holleran Jan. 2, 2012, 1:19pm


A Madison County woman claims her health insurance company refuses to reimburse her for medical costs she incurred after a trip to the hospital.

Molly and Robert McAfoos filed a lawsuit Dec. 15 in Madison County Circuit Court against Celtic Insurance Company.

In their complaint, the McAfoos allege Molly McAfoos was admitted to St. Anthony's Medical Center on May 3, 2010. During her hospital stay, Molly McAfoos racked up a medical bill, according to the complaint. The McAfoos do not specify why Molly McAfoos went to the hospital.

After her visit, she submitted a claim to Celtic, her insurance company, the suit states. However, Celtic refuses to reimburse her for her costs, the complaint says.

She blames Celtic for refusing to pay her bill without a medical basis, for failing to conduct a reasonable investigation into her claim, for failing to inform her of its basis to fail to remit payment and for failing to provide her with a reasonable appeal process.

In their complaint, the McAfoos seek a judgment of more than $250,000, plus costs.

Larry Darr of Schrempf, Kelly, Napp and Darr in Alton will be representing them.

Madison County Circuit Court case number: 11-L-1363.

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