Tactics Companies Use in a Health Insurance Claim Denial

By  //  June 11, 2021

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Hire The Right Lawyer Seasoned in Health Insurance Claim Denials

Lawyers embrace many different types of expertise. For example, the expertise of one specific lawyer is handling cases when your health insurance denies your claim for payment.

In addition, there are various circumstances and hundreds of other insurance companies with different policies governing what they will pay or not pay. Most apply unfair treatment and tactics, so they do not have to pay you or pay you less than what you are entitled to receive.

Therefore, it is best to hire a lawyer to defend your right to health insurance claim payment. This lawyer knows all of the various tactics that insurance companies use to deny payment. We are talking about your health insurance, not your automobile insurance. There are differences between these types of insurance companies. Sometimes these two insurance companies overlap regarding your right to health insurance payments. Let a seasoned lawyer sort out your situation. 

For instance, you have mounting medical bills due to injuries sustained in a car accident, and you start filing claims with your health insurance company, and the company denies payment. In this case, your auto insurance is the primary company that pays for your medical bills after an accident. 

However, it would be best if you met certain limits of your automobile insurance policy before your medical insurance begins to pay your medical bills. You can file a claim against the other driver’s insurance company to pay your medical expenses in some states. 

Insurance companies seem to be your friend, and the agents do all they can to keep you as a customer until you are in an accident or have medical issues and begin to file claims for health insurance payment.

After that, insurance companies do not want to pay you any more than they absolutely must or may start denying payments on your health insurance claims. These insurance companies use an array of tactics to deny a health insurance claim. Never become a victim to tactics because your financial future may depend on the outcome of your case. 

These companies tell you that they have your best interests at heart to protect your finances. However, many do not always support you when you need a claim paid. It is best to hire a lawyer to deal with insurance agents and their companies. Attorneys know what tactics health insurance companies often use against you.

Seasoned lawyers know how to work around these tactics. However, you probably do not have the expertise, knowledge, or power to get yourself the best possible settlement. An agent knows that once you settle for a less than adequate payment and sign on the dotted line, you can never file another claim for the same case.

What Tactics Do Insurance Companies Use?

The following examples are what insurance companies may use against you to deny your health insurance claim:

■ Insurance companies attempt first to minimize your payments.

■ Insurance companies will not settle for a fair and just payout if the settlement is too large. Considerable compensation under any circumstances is fair and just for you, but the insurance company does not feel it appropriate to them, so it fights against payment.

■ Insurance companies try to push through settlements as quickly as possible and instill fear in you if you do not accept the payment.

■ Insurance agents may harass you with phone calls and visits to offer you a less than adequate settlement. The agent may tell you that no other offers are available if you do not take their offer. However, you have mounting bills and feel you cannot wait, so you accept the offer. You learn later that the proposal was not nearly sufficient to take care of your needs.

■ Will always attempt to settle for less than you deserve

■ Insurance companies never consider your future complications.

■ Insurance adjusters try to minimize your injuries or damage.

■ Companies appoint their doctor to examine you, and they are biased towards the insurance company, claiming that your injuries are not as bad as your doctor suggests. You may find this tactic in places of employment. Companies have an appointed physician that works for them. This company doctor may tell you that the treatments you received were not necessary.

■ Insurance agents try to prove that your injuries occurred before your accident.

■ When it comes to paying a fair and just settlement, these companies are experts at placing liability on someone else so that they do not have to pay the claim.

■ Insurance agents may try to prove that it was your fault because you were involved in risky behavior.

■ Insurance companies try to prove that you were negligent in seeking the proper medical care.

■ Insurance companies and agents work hard to gain your trust but are not on your side in wanting you to record your statement. They are looking for a minor slip in your comments that jeopardizes your claim. They try to use your honest words against you.

■ Insurance companies push you to sign paperwork. They tell you that this is the routine and their standard of practice. You could be signing away your rights to a fair and just settlement. Refer them to your attorney to review all paperwork first.

■ If you win a sizeable settlement, your insurance company may put off paying you in the hope that you will accept a smaller settlement. You find it difficult to wait for payment when the bills keep mounting. Your attorney works for your right to timely payments. 

Insurance Companies’ Legal Responsibilities

Insurance companies must investigate and evaluate your claim fairly and promptly. When approval for a medical procedure is urgent, it is your right to get prompt approval. However, when the insurance company neglects critical approval, it is time to call a denied health insurance claim lawyer to help you. 

A Call to Action for Adequate Health Insurance Payments

Has your insurance company denied you a claim? A denied health insurance claim lawyer has expertise in the field of denied insurance claims. Make sure to find a lawyer who has a successful track record for winning health insurance claim cases. Lawyers know that many insurance companies put their profits ahead of your health and wellbeing. You have legal options and rights under the law when health insurance claims are unfairly denied. 

Through the expertise of an attorney, rest assured that they will cover all of the above bases so that the insurance company has no tactics left to deny your claim or pay you much less than you are entitled to receive. 

A denied health insurance claim lawyer will take an in-depth look at your case and calculates all the past, present, and all possible future bills needed to adequately cover all of your expenses so that you have nothing to worry about except your healing process. Never take the risk of losing everything you have worked so hard to achieve.  Never risk your financial future due to denied health insurance claims.