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Health Insurance Denials

When you or a loved one requires medical treatment, you immediately turn to your doctor for advice, as your doctor knows the best treatments and medications to help your situation. However, frequently, insurance companies deny reasonable and necessary medical treatments, procedures and medications simply because it saves the insurance company money despite the health repercussions to the client. Nevertheless, there are a few steps you can take to protect yourself and your loved ones from such actions:

First, it is vital you obtain a written statement or letter from a medical doctor that states the treatment, procedure or medication prescribed is “reasonable and necessary”. You should also send a copy of the doctor’s written statement to your insurance company.
Second, it is important that you have a thorough understanding of the insurance company’s procedures for filing both a claim and an appeal. In many cases, insurance companies will ignore a claim until it has gotten to the appeals stage. .As it is only when the claim is appealed that the insurance company responds as that is when the requirement to potentially pay you for your claim exists. Do not miss deadlines required by the insurance company and make sure to document and keep copies of all correspondence and appeals that you submit to your insurance company.

Third, in cases where treatments, procedures and medications are so costly and has devastating consequence on financial as well as the physical health of the claimant, the best course of action is to contact a qualified attorney who is experienced in litigating matters related to denial of health insurance benefits.

If you or your loved one has been a denied health insurance benefits, contact an experienced litigation attorney at The Evans Law Firm. You may also call us at 415-441-8669 or e-mail us at for a free and confidential consultation.

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