Health insurance claim denials can be exceedingly difficult to handle from both a financial and emotional perspective. In health insurance claim disputes, not only are you saddled with the unique challenge of having to recover from your injury or illness, but depending on the circumstances (e.g., if your insurance provider makes a significantly undervalued offer or denies your claim entirely), you could be left with significant bills. Whether your health insurance provider chooses to cover your treatment could spell the difference between bankruptcy and solvency – and in many cases the difference between prompt treatment that can save a patient’s life and an unknown future. The stakes in health insurance disputes are often rather high. If your insurer acts in bad faith, you may therefore be entitled to recover damages for emotional distress, among various other losses.
It is common for life insurance companies to wrongfully deny a legitimate claim for benefits, or to otherwise interfere with the processing of a legitimate claim through an unreasonable delay. These actions can put serious pressure on the policyholder and/or their beneficiaries.
If a life insurance claim is denied, for example, you may be forced to appeal the denial through an internal administrative process, or, if that does not resolve the issue, to sue the insurer in a court of law. When grieving for a loved one, the prospect of an ongoing legal conflict may seem daunting.
Disability Insurance / ERISA
Whether you have disability insurance coverage through your employer or independently through your own personalized insurance coverage, you are entitled to receive disability benefits if you have a qualifying condition. Insurance policies can vary considerably. A disability insurance lawyer can assess your plan and the language of the contract and determine the obligations that apply to you, the claimant, and those that apply to the insurer. Understanding the provisions and language of your disability insurance policy and how it will be enforced is critical.
Many people – especially breadwinners – purchase multiple types of insurance to protect their loved ones in the event they are killed or incapacitated and unable to work and provide financially. One of the types of insurance commonly purchased is called Accidental Death and Dismemberment, a category of life insurance that only pays out a benefit when the insured is in a covered accident that causes death or specific serious injuries.