What are my legal remedies if a health insurance company or plan refuses to pay a claim for a benefit or service?
Total Comments: 2
Posted: Wed Dec 02, 2009 10:20 pm Post Subject:
that depends on your situation.
why has your claim been declined and what actually happened to you?
Ultimately there is probably the avenue of taking the insurer to court, but you'd probably want to have a pretty good case before you even look into that.
Posted: Thu Dec 03, 2009 06:49 am Post Subject:
Not that insurers don't make incorrect denials of claims, but it is likely that they are declining to pay a claim because it is for something not covered by the policy. As "Heidrek" requests, it would be helpful to have more information.
It's like asking, "Can I cross the street now?" without telling us that the "street" you're trying to cross is the Indianapolis Motor Speedway while the "500" is in progress.
In any event, long before you would consider getting an attorney, if you feel an insurer has unfairly denied a claim, your state department of insurance is a better first resort. Simply file a complaint with them and allow them to investigate. They are prevented by state law from intervening once you have retained an attorney or filed a legal action in the courts.
Posted: Wed Dec 02, 2009 10:20 pm Post Subject:
that depends on your situation.
why has your claim been declined and what actually happened to you?
Ultimately there is probably the avenue of taking the insurer to court, but you'd probably want to have a pretty good case before you even look into that.
Posted: Thu Dec 03, 2009 06:49 am Post Subject:
Not that insurers don't make incorrect denials of claims, but it is likely that they are declining to pay a claim because it is for something not covered by the policy. As "Heidrek" requests, it would be helpful to have more information.
It's like asking, "Can I cross the street now?" without telling us that the "street" you're trying to cross is the Indianapolis Motor Speedway while the "500" is in progress.
In any event, long before you would consider getting an attorney, if you feel an insurer has unfairly denied a claim, your state department of insurance is a better first resort. Simply file a complaint with them and allow them to investigate. They are prevented by state law from intervening once you have retained an attorney or filed a legal action in the courts.
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