Health insurance policyholders file policy claims to assist in the payment of medical treatment and care. It is the main purpose of having an insurance policy in regards to your personal care. All too often, health insurance companies will unjustly deny a valid claim. Even worse, they will cancel a policy after a claim has been filed. In situations like these it is necessary to seek guidance from an experienced legal professional.
Insurers are obligated to pay claims in a timely manner and in accordance with the wording in their policies. In order to support the claim denial, an insurance company may attempt to use the policy language to their advantage. This is not uncommon, as insurance companies continuously look for ways to reduce costs and increase profit.
When a claim has been denied, it may be subject to an appeals process. Appealing a claim usually begins by contacting your insurance company. The typical method of contact is a mailed letter. This sounds simple, but a poorly written request could result in an appeal being rejected. Professional writing can increase the chances for denied claim to be reversed, especially when citing specific examples that are often only known with being within health insurance litigation for some time.
The legal basis for appealing a denial can also be complex, and upholding a claim against an insurance company is a difficult task. The claimant will be required to produce evidence that substantiates receipt of the benefit. This may include proving medical necessity or a detailed critique of the denial.
If a valid claim has been denied, or a policy has been cancelled, an insurance litigation attorney will help ensure the policy terms are honored. They will represent policyholders so they receive the health coverage they are entitled to. Understanding this type of law can be the difference in the continued denial, or acceptance, of a claim.
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