When Your Health Insurance Company Won’t Pay For Your Care

When Your Health Insurance Company Won’t Pay For Your Care

If your insurance company notifies you that it won’t pay for care that your doctor says you need, it can be frightening. It’s almost overwhelming to think about trying to fight them. You’ve paid for insurance and worked hard to make payments on-time. Health insurance premium payments are one of the biggest expenses that most people have after paying their mortgage.
You can fight back, and you do have rights. If you can show that your insurance company denied your benefits in “bad faith,” you may be able to sue the insurance company for additional damages in addition to making them pay for your care.

What Does “Bad Faith” Mean?

Bad faith means an insurance company is unreasonably withholding payment for coverage that you’ve paid for. An insurance policy is really a contract between you and the insurance company. You are required to pay your monthly premiums in exchange for the security of knowing that the company will pay for claims. This concept is true whether the policy covers your car, your house or your health.
When you keep your end of the bargain by paying your premiums, but the insurance company doesn’t, that’s just wrong. If they look for a way to avoid investigating or paying a legitimate claim, they are acting in bad faith under the law.

When Your Health Insurance Company Won’t Pay For Your Care

Should My Policy Cover My Care?

That’s one of the first things we’ll investigate. Every policy is different and covers—or excludes—care that you may not realize is excluded. That’s why it’s important to consult with a lawyer familiar with these claims as soon as possible. However, there are certain basic coverages that federal law now requires in every policy:

  • Coverage for pre-existing conditions
  • Preventative care without charge
  • Expanded coverage for young adults

How Can a Lawyer Help?

In some cases, when a lawyer gets involved, the insurance company starts to take your case more seriously. Often, we can resolve the situation by contacting your insurance company and reminding them what the law says. In these cases, the insurance company can avoid a bad faith claim by paying for your care as it should have from the beginning.
In other cases, if the insurance company denies your claim, we can file a bad faith lawsuit against them. If we determine that the insurance company acted in bad faith, we must prove that they withheld your benefits and that they acted unreasonably by doing so.

Contact Us for Help

We can help you recover not only the benefits to which you are entitled, but additional compensation for your financial losses and pain and suffering. Contact us to learn more about whether you may have a Bad faith insurance claim and how we can help you.

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