And it is always better to let the insurance companies compensate you for the damages rather than you shouldering it yourself.
Filing for a claim doesn’t mean that you’ll necessarily get it, as insurance companies would rather delay claims or even deny them as it is in their best interests. To ensure that you always remain on top of the insurance companies and your settlement, our team at Ehline Law has gotten together some indicators to let you know of unfair refusals for your insurance benefits.
Some victims deserve their insurance benefits, however, an insurance company will try its level best to use the law or even unfair practices to avoid giving insurance benefits to their clients. The more compensation cases they process, the lower the insurance company’s profits, and this does not work in their best interest at all.
If you’ve got news of denial of your insurance coverage, then you have two options to consider:
An internal appeal requires you to ask the insurance company for a full and fair review of your claim while an external appeal requires you to seek independent third-party help and in this case, a lawyer.
Having an insurance product or a health plan is not sufficient when it comes to dealing with insurance companies. You must know the policy obligations and the conditions stated in the health plans to be able to understand if your claim falls under the liability coverage by the service provider. If your claim is reasonable to receive compensation, you should file for an appeal or get a lawyer to help you out.
A delay in medical treatment can oftentimes lead to wrongful death and we’ve seen multiple cases where a policyholder gets their claim denied by the issuing insurance carrier resulting in a halt in their medical treatment causing wrongful death.
According to federal and state laws, insurance firms need to expedite claims in a timely manner within a certain number of days so that policyholders can start their medical procedures. A delay can be a difference between life and death resulting in a bad faith claim that you can file for. Any such insurance product has an insurer underwriting that ensures guaranteed payment in case of loss or damages.
These financial firms use medical providers and doctors to deny claims.
Some of the tactics include the following:
When you face unfair denial for the claims you were looking forward to, you can appeal the unfair denial, however, there will be a certain time period where you can make an appeal. Many insurance policies encourage appeals rather than courts as they are expensive and time-consuming for these health insurance companies to deal with.
You can handle your own unfair denials by appealing without the need for a lawyer. Simply read on your insurance policy and follow the guidelines for an appeal. You might need the following documents depending on your policy:
You also need to go through the claim file to determine any legal holes or incorrect facts that the insurance company is making. These statements, if found, can create a strong case for you to fight. You would also need a statement that identifies your disabilities if you have any and how the unfair denial will impact your life. Having additional witness statements is a great way to represent yourself.
Dealing with insurance companies is time-consuming and also requires diligent care when analyzing documents. Having an expert attorney to deal with insurance carriers is a great way to remove this responsibility from your shoulder and let the experts handle all the dirty work while you recover from any injuries or losses.
We will analyze the applicable insurance policy, submit an appeal by completing the documentation for cash compensation, collect evidence from Medicare experts and prove your case with the health insurance providers.
Our law firm will provide free case review to understand your situation and guide you on the next steps by giving legal advice. We’ve got years of experience with bad faith insurance claims so let our attorneys ensure that the insurer pays the price for any damages to you or your family.
Michael is a managing partner at the nationwide Ehline Law Firm, Personal Injury Attorneys, APLC. He’s an inactive Marine and became a lawyer on the California State Bar Law Office Study Program, later receiving his JD from UWLA School of Law. Michael has won some of the world’s largest motorcycle accident settlements. He compassionately helps clients recover after serious injuries.