What should an insured do if the insurer does not send claims forms within the time period stated in a health policy's Claims Forms provision?

Submitting the claim in any form is the correct approach if an insurer fails to provide the necessary claim forms within the timeframe specified in the health policy's Claims Forms provision. This is grounded in the principle that the insured has the right to receive benefits they are entitled to, regardless of whether the insurer has fulfilled their obligation to send forms.

When the insurer does not provide the forms, it can be seen as a failure to fulfill their duty, which means the insured is not dependent on the insurer's actions to initiate the claim process. By submitting a claim in any form, such as a letter explaining the circumstances and detailing the necessary information regarding the medical services received, the insured can still assert their right to treatment costs.

Choosing to wait for the insurer to send the forms would be impractical, especially if medical expenses need to be addressed promptly. Filing a complaint with the state insurance department may be a valid course of action later on, but it doesn't resolve the immediate need to submit a claim. Similarly, seeking legal assistance can be an option, but it's typically a more drastic measure that might not be necessary at this stage of the claims process.