Reservation of Rights: What Does It Mean When Your Insurer Issues This Notice?
January 6, 2025
Yes or no, black or white, true or false? Life consists of choices and decisions. While some are straightforward, others are less so. This is particularly true when it comes to insurance claims. In fact, not every claim submitted is immediately paid or denied. In fact, insurance companies in Oklahoma and across the nation respond to many claims with reservation of rights letters. In general, these are notifications of indecision. But not everyone recognizes why this documentation is sent, what it means, or how to react. In fact, these letters may be a red flag indicating that your claim may, in fact, be denied. If you have received a reservation of rights letter you should consider speaking with an Oklahoma insurance dispute lawyer. Their perspective on your situation can guide your actions and he... Read more
ERISA Claims: What You Need to Know If Your Health Plan Is Through Your Employer
December 22, 2024
Managing Your ERISA Claim Can Be a Formidable Process Do you have insurance through your labor union or private sector employer insurance plan? If so and you have become ill or even disabled due to a serious illness or the impact of an injury, you may be able to file an ERISA claim for benefits. As you are well aware, the cost of medical care can be considerable, and these expenses are only the tip of the iceberg when considering your future. If you are disabled or so seriously ill that you are unable to return to work for a period of time or permanently, the financial impact on your life can be devastating. You may have coverage that can help alleviate these expenses. Unfortunately, filing, appealing, and litigating ERISA claims and obtaining the benefits to which you are entitled can be challen... Read more
Denied for a ‘Technicality’? Don’t Let Your Insurance Company Hide Behind Fine Print
December 15, 2024
Details, details, details!! If you have received an insurance claim denial, you are likely well aware that the reasoning behind their refusal to pay may not be based on something major. Often, it’s the little things, the small issues we refer to as ‘technicalities.’ Unfortunately, even seemingly minor technicalities can result in an insurance claim denial, placing the financial burden of treatment or services on you. These expenses can be financially devastating and, ultimately, life changing. If you have received a denial letter from your insurance carrier due to a supposed technicality, it can be worthwhile to engage the assistance of an Oklahoma denied claims attorney to assist with your appeal. Insurance policy language is complex, as is insurance law. Working with an experienced and ... Read more
How to Appeal a Health Insurance Claim Denial
December 3, 2024
Knowing how to appeal a health insurance claim denial is essential. Accepting your insurance company’s decision as final leaves you responsible for the cost of your treatment. In Oklahoma policyholders have the right to both an internal appeal and an external review if the insurer’s decision is not in their favor. If your claim has been denied, navigating the appeals process can be overwhelming. Engaging the assistance of a seasoned health insurance claims denial attorney can be valuable. Fighting a Health Insurance Claim Denial Has your health insurance claim been denied? If so, you should contact an Oklahoma insurance claim lawyer experienced in the appeals process. Engaging the knowledge and experience of an attorney can be the difference between success and failure for your appeal. Working wit... Read more
Time Limit for Appealing Denied Insurance Claims
November 15, 2024
You may have heard it said that time is a valuable commodity. This is true in much of life; you always want to be able to leverage time on your behalf. That said, in some instances it is particularly important . . . like when you have received a denied insurance claim notification. Being told your insurance company is refusing to pay your claim is concerning. Because you will not receive the coverage you expected, you may find yourself responsible for your costs (or even unable to get the treatment you need). This can negatively impact your finances, both today and in the long-term, as well as harming your health and well-being. During times like this, engaging an Oklahoma denied claims attorney may be in your best interests. This professional not only understands and appreciates the filing deadlines,... Read more
Denied Insurance Claims: A Delay Tactic Used by Insurers
November 5, 2024
The Problem of Delayed and Denied Insurance Claims Insurance companies deny many claims even though they know they will end up paying them in the long run. Unfortunately, delayed and denied insurance claims are a common problem faced by many in Oklahoma and across the country. Individuals purchase their insurance policies in good faith; they believe their claims will be paid completely, in accordance with policy language, in a timely fashion. Unfortunately, this is not how the insurance industry operates. In an effort to maximize profitability by minimizing expenses, insurance companies throughout the state regularly deny claims either hoping their policyholders accept their word as final or to gain the financial advantage of holding onto the monies owed longer. Multiple problems occur when insurance ... Read more
Health Insurance Claim Denial Reasons
October 18, 2024
Health insurance claim denials happen frequently and are concerning to those who receive them. Medical care is costly, and being asked to cover unreimbursed claims is a burden. Understanding why your claim was denied is important; this knowledge can help you appropriately address the decision. The reasons for denial vary based on the situation at hand and the language of your policy. In some cases, they may be legitimate. Perhaps your claim wasn’t submitted appropriately, or maybe the care you received was not covered. That said, your insurance company may have also failed in its duty to serve you in good faith. Whether the denial was for a small amount of money for a simple procedure or a costly, possibly life-saving treatment, you should take action. If you think your claim denial was a mista... Read more
Evidence You Need to Appeal a Health Insurance Claim Denial
September 30, 2024
Understanding Health Insurance Claim Denials Nobody ever expects to receive a denial notice from their health insurance company; yet every day individuals in Oklahoma and throughout the country find out that their claims were rejected. These notifications are more than surprising -- for many they are devastating. Medical care is costly, and most individuals are not in the position to pay out of pocket for the treatment they need. In some cases, these denials are made in response to a request for pre-authorization for necessary medical treatment. While denials are commonplace, not everyone who receives one realizes that they have the right to appeal. That said, the appeals process is intentionally complex. Navigating it successfully requires gathering a great deal of evidence. In many cases, engaging a s... Read more
Suing a Health Insurance Company for Bad Faith
September 8, 2024
Do you believe your insurance company has delayed, denied, or underpaid your claim in bad faith? This means that their decision was both incorrect and purposefully made. Examples of bad faith insurance practices include: Failing to appropriately and promptly investigate your claim Purposefully underpaying your claim Misrepresenting your policy’s language Threatening you Employing biased experts for the review process. This list is just a sampling of the bad faith strategies employed by Oklahoma insurance companies. Every day insurance companies act immorally and illegally in order to minimize their expenses and maximize their profits. Those hurt are their policyholders who need these claims to be approved to obtain necessary medical treatment or to reimburse them for their expenses.... Read more
Top 5 Questions to Ask Before Hiring a Health Insurance Lawyer
August 28, 2024
The Importance of Choosing the Right Health Insurance Lawyer If your health insurance claim has been denied by your insurance company, you are likely feeling a host of emotions. You may be frustrated, because you did everything you were supposed to do. You may be aggravated, because you know that resolving your issues is going to take a lot of time-consuming work. And you may be worried, either because you cannot afford to shoulder your unreimbursed costs or because your health is in danger as your insurer refused to provide preauthorization for necessary treatment. The good news is that your insurance company's initial decision may not be their final word. You have the option to launch an appeal. The bad news is that this process is time consuming and requires knowledge and experience to complete s... Read more
