I became ill last year and after a couple trips to the ER I decided I should quickly get insurance so they would keep treating me. So I bought "temporary insurance" whereby they don't pre-check your medical history, and only investigate for pre-existing conditions if you have claims. Well, I have an enormous amount of claims made with them now, and I was entirely sure that my condition was pre-existing due to the ER visits for basically the same thing, pre-insurance. You can imagine my shock and relief to find they determined my condition was not pre-existing and will be paying most of my $14,000 in bills. I provided them with the names and addresses of previous doctors (including the ER I was at pre-insurance), as they requested. So, of course I didn't argue with them when they said they were about to pay. My only question is, if they later decide that I should have told them that I thought they may have made an error would I be held criminally liable? Or should I just keep my mouth shut and chalk it up to their loose guidelines?

By "they don't pre-check your medical history" do you mean that they did not require a physical exam or review of your medical records, or that they did not ask you any questions about your health history during the application process? I can't imagine a company accepting someone even on a temporary policy without looking into their health history, which would generally ask about symptoms or treatment of various conditions, ER visits, hospital stays, etc. Especially since some "temporary" policies can be converted into regular plans, and they would need to assess that person's risk. Whether your scenario amounts to insurance fraud or luck I guess would depend on whether or not you were completely truthful during the application process.

I'd keep my mouth shut and just thank GOD!
You are lucky.... besides... insurance companies have taken so much $$$ from so many other people with pre-existing conditions or just left them hanging in the dark without coverage. I think it's kind of nice to hear they get
get stuck with the bad end of the deal once in a while too.....

Keep you mouth shut !!Think of all those poor people down in NEw Orleans and how the insurance companies screwed them out of there homes and everything in them , really and the price of car insurance , how high it's gone ......really bonus to you fro getting $14000 out of them ! Really don't be foolish and tell them it was a pre existion condition ! There is only one word for that and smart isn't it ..........so be smart and keep it to your self .

I became ill last year and after a couple trips to the ER I decided I should quickly get insurance so they would keep treating me. So I bought "temporary insurance" whereby they don't pre-check your medical history, and only investigate for pre-existing conditions if you have claims. Well, I have an enormous amount of claims made with them now, and I was entirely sure that my condition was pre-existing due to the ER visits for basically the same thing, pre-insurance. You can imagine my shock and relief to find they determined my condition was not pre-existing and will be paying most of my $14,000 in bills. I provided them with the names and addresses of previous doctors (including the ER I was at pre-insurance), as they requested. So, of course I didn't argue with them when they said they were about to pay. My only question is, if they later decide that I should have told them that I thought they may have made an error would I be held criminally liable? Or should I just keep my mouth shut and chalk it up to their loose guidelines?

Was your condition diagnosed in the ER? If not, then they might not see the condition as pre-existing, and if, as you said, they determined with all the information that they requested that it was compensable then they made the decision with all the information that you had at your disposal.
I say not to worry about it, if it was a mistake, then it was a mistake in your favor...
I had a fluid overload in a surgery in 1999 causing heart failure, but the insurance covering the surgery said that I could not prove that I did not have heart failure before surgery so they would not cover any treatment for my heart failure (it was a workman's comp surgery) and my regular insurance will not cover it because they say it was caused in the surgery... both were taken to court by me and BOTH won. Basically, before you have a surgery you do not have to have a medical clearance to tell what you have, but you instead need a doctor to list every single thing that is NOT wrong with you.

So... I say just trust the insurance company's decision and let them pay the bills, you did not set out to defraud and in their eyes no fraud is in place, nor in my eyes.