Can I File Legal Action if My Insurer Denies or Underpays a Healthcare Claim?

If you recently submitted a claim to your health insurance provider and received notification that your claim was denied, it is important not to panic. If you have been a responsible policyholder (by paying your insurance bills on time, avoiding gaps in coverage, etc.) and you believe that your claim should have been properly paid out, chances are that one of three things has happened. First, you or your health care provider may have made a minor mistake when submitting your claim. If this is the case, an experienced insurance claims denials lawyer can help you to right that situation and avoid unnecessary red tape so that you can receive your rightful benefits as soon as possible. Second, the insurance provider may have made a mistake when processing the claim. If this is the case, your insurance claims denials lawyer can work with the insurer to work through that mistake and rectify that situation. Third, your insurance provider may be acting in “bad faith” by intentionally denying your legitimate claim. This is unacceptable behavior but it does occur with startling frequency. In this case, you may need to file legal action in order to receive both your rightful benefits and additional monetary compensation for the harm the insurance provider has caused you.

Bad Faith Claims for Healthcare Matters

The thought of filing legal action in order to receive your rightful insurance benefits can be understandably intimidating. However, an experienced insurance claims denials lawyer can help you to navigate this process as efficiently and effectively as possible. Most attorneys do not handle insurance claim denial cases. But those that do and are highly experienced in these matters know just how to approach both mistake-based challenges and bad faith situations. It is important to understand that if you have been wrongfully denied benefits for a legitimate healthcare claim, you are not alone. A staggering number of Americans deal with this reality every year – and unfortunately, not every policyholder knows that they have rights to rightful payment under the law. When an insurance provider (either mistakenly or in bad faith) rejects or underpays a claim that should rightfully be paid per the terms of a current policy, that insurance provider must either right the situation or risk being held accountable in court. Too few policyholders file legal action against healthcare insurance providers when such action is warranted. An experienced insurance claims denials lawyer can help you to navigate filing a legal claim if it is necessary and appropriate to do so.

Bad Faith Claims Legal Guidance Is Available

Whether you are sure that you should be rightfully reimbursed for a claim that has been denied or you are unsure if you are entitled to benefits under your particular circumstances, schedule a risk-free consultation with an attorney, like a Chicago insurance claims lawyer, today. Once you understand your legal options, you can make an informed decision about how you want to move forward. 

Thanks to Childress, Lockus, & Plunkett for their insight into denied insurance claims.