it can. all they have to do is dishonestly argue that whatever you did isn't part of what they cover and refuse to pay. now it's on joe plumber to read the fine print, call the company and argue with them and prove them wrong, and if they still refuse to pay it's now on joe plumber to hire a lawyer and sue. sure they might lose eventually if it goes the whole way, but 99.99% of the time it won't get that far, the insurance company is just going to get what it wanted and the customer gets fucked with medical bankruptcy. about the only real check on that is the threat of a class action lawsuit and negative press, which only means they can't do it too often.
United States