I’m looking for some clarification please. In my policy book for benefits there is a section called Medical Coordination Benefits. It states that:
" Medical coordination is a process of early involvement to ensure that you are diagnosed quickly and receive appropriate medical treatment on a timely basis. The goal is to enable you to return to work as early as possible and to prevent the disability from becoming long term or permanent."
I live in the north and when I first got sick and I was having trouble getting a doctor (in the northern communities there is a travelling doctor who visits every 2 weeks and changes) I reached out to my insurer to get help getting medical care. I’ve reached out multiple times and then gave up. I’m now almost 3 years off of work and my symptoms are still undiagnosed and worse than when I first got sick. I tried to explain to them that getting referrals take forever up here - I’m currently on the wait list for a few referrals and my doctor just informed me that I might be waiting over a year for some. My insurer did not comply with this portion of my policy. I feel because of it I have suffered longer than I need to. Is there anything I can do? What happens if they did not comply with this portion of the policy?