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Health Insurance Claims

Health insurance is insurance that pays for medical care when you are sick. Medical bills can become extremely expensive, and if you face a medical emergency without health insurance, the financial consequences can be extreme. If you are unjustly denied coverage for treatment, you may need to file an appeal.

If you are experiencing legal issues with your health insurance company, or if you are a representative of a health insurance company that is being accused of fraudulent or illegal activity, it may be time to seek legal assistance. An individual is entitled to appeal directly to the insurer if:

  • Payment for care is denied
  • Insurer rules care is unnecessary
  • Insurer deems individual is not eligible for a particular benefit
  • Insurer claims treatment is experimental
  • Insurer claims individual has a pre-existing condition

If you are a healthcare representative who has been accused of illegal activity on behalf of the insurance company you represent, contact an attorney today to provide legal guidance.

Should I Hire a Health Insurance Attorney?

If a health insurance provider is not paying for enough of a claim that has have submitted, and the individual believes he or she is entitled to reimbursement, they may be able to press charges. If you represent a health insurance company, consult an attorney about your case today. Though your company most likely has legal representation, it is wise to obtain your own representation to ensure your rights are protected and your name is cleared of all charges brought against it. Attorneys with expertise in the health insurance arena can help you figure out if you can be held accountable for any part of the situation, and explain to you what recourse you may have.

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