The two thousand dollar bottle of Bulleit

Pay it right away and try to file a claim with the insurance afterward? I can say that i know that this rarely works out easily. You want to call your insurance and talk to them. If you were insured at the time this happened they'll mop it up from there. I've been in a very similar situation, and i ended up derailing the train just after the insurance company part because i was two days outside my insurance being active(i fucking HATE this country sometimes), but it seemed like if i hadn't been they would have just sorted it then and there.

The "tax collector" thing may be weird and should be fully investigated, but it could also well be legit. In San Francisco, most ambulance calls are handled by the Fire Department and bills come from the city for these services (some calls are covered by commercial ambulance services instead). You could contact their http://www.sf-fire.org/index.aspx?page=43 directly if you want to verify who you're dealing with.

I'm not saying you should resist/refuse this debt, but the processes described in http://strikedebt.org/The-Debt-Resistors-Operations-Manual.pdf (from StrikeDebt.org) may give you a good guideline to establishing whether the debt is legitimate and legal.

If you contact the Fire Department, they'll have records from your ambulance call. Those records should detail when they arrived, what tests they performed, and whether they transported you. Ask for copies. Ultimately, if they provided you with medical services, and especially if they transported you to the hospital, you're pretty much responsible for the bill. Your options basically boil down to:Try to get insurance to pay for it. This may be difficult because they'll probably say it's too late to file a claim. Other people may have suggestions hereWork out a payment plan and discount with the City. They may be willing to come down on the price, especially if you make it clear you're paying yourself and insurance won't be covering it.Pay in fullDon't pay. Risk hurting your credit and having collections action taken against you.

Just a couple of notes that are typical of an ambulance service: - No matter who makes the call on your behalf, you're responsible for the ambulance charges. - If you don't take the ride, you're still responsible for the ambulance arriving amount. - If you're under 18, I believe you aren't 'allowed' to refuse the ride.

I had a hospital bill go to collections (I got several other bills from the same visit because America, which I settled up, but the fourth bill never actually reached me -- the hospital's own billing department didn't even know about the last bill or who to put me in touch with at first [!]). I resolved it by calling the hospital directly and explaining the situation. There was definitely a lot of phone tag and being shuttled around between various hospital employees but I did finally get to someone who could help me. Basically, because it was pretty recent, they were able to pull the debt back from the collectors, wrangle my insurance and settle with me directly. Wrangling insurance is hard on your own; health care providers in the USA do it full-time so you want to let them do it if at all possible. I was pretty broke at the time but they were very cool about letting me pay back the remainder extremely gradually. The catch is that this was only a few months, not four years, and it was a private collections agency, not a municipality, but it's worth a try. The worst they're going to tell you is "no, you have to settle with the city" or "you can settle with us but your insurance won't cover it." Even if your insurance won't take it, you may still be able to cut a deal with the ambulance billing department for less than the total quoted amount of money. Insurance may have negotiated their full-price rate down a bit anyway, and if it's really a private company, I bet they are not getting much money back from the city through collections as it stands now. Bill collectors buy debt very cheaply. I really feel your pain about the unfortunately pretty typical cost of your ambulance ride. Mine was only a few blocks.

Let me recap, if I understand. You are being asked to pay a debt that you were not billed for in the period in which your insurance normally covers it, which is not actually your fault. You need specific advice on what to do next from a legal practitioner who wants you to get the best deal you can. This is so obviously Lawyer Time that I'm kinda surprised no one has said that you need one yet. So: You need a lawyer.

I would call your insurance company first. They were covering you at the time, so you want them to pay.

Ambulance service being billed through the city is very common in the US. And if you don't pay it is indeed the city tax collector who will eventually come asking for payment, so that is not weird in and of itself. I've seen wages garnished by a city for this very thing (but in NC). Looks like you can appeal the bill and/or file for financial hardship in San Fran. Link http://www.sf-fire.org/index.aspx?page=43 Best of luck.