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Old 20.01.2020, 15:52
reza_p_o reza_p_o is offline
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Rejection of accident insurance coverage after a year

I had an accident in July 2018, and the accident insurance (through my employer) agreed to cover the incident. During this time, they have continuously paid for my doctor visits, medication, physiotherapy, chiropractic, etc with no problem.

This week however, they sent me a letter saying that they have reevaluated my case by external doctors, and concluded that they should have stopped the coverage 3 months after the incident (Oct. 2018). They also mention that they will not reclaim the paid bills, but will not pay the outstanding ones (those before they notified me) or any new ones.

Assuming that I am covered by the accident insurance, I have not followed the protocol of my health insurance over this time (I had a pharmed plan with Assura). For example, I didn't get the medication from Assura designated pharmacies, I went to a specialist without a referral from a family doctor and also visited an Osteopath.

Now here is my question:
Can the accident insurance stop paying the bills retrospectively? Is there a clause in the law that allows them to do so?
Do I have any grounds in asking them to pay the previous bills that are not covered by my health insurance?
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