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.
As a general rule, insurers are incentivized to avoid or minimize their potential liabilities, even when a policyholder clearly qualifies for benefits under their coverage contract. By ramping up the administrative cost for the policyholder, insurers can effectively reduce their benefits liabilities and undermine the ability of policyholders to challenge the legitimacy of their actions.
Successful insurance litigation requires client-oriented legal representation from beginning-to-end of the process. At Raval Trial Law, LLP, our Houston insurance coverage and litigation attorneys have decades of combined experience representing policyholders against their insurers for wrongful denial, delay, missed payments, underpayment, and other issues entitling the claimant to challenge the decision of the insurer.
When it comes to health insurance, an injured policyholder who requires significant medical treatment may find themselves in a situation where they are held hostage to the whims of their insurer. If an insurer denies your claim, underpays your claim, or delays payment, you could be left in financial limbo with no means with which to pay your medical bills. An experienced Houston health insurance lawyer can help you recover the compensation you deserve.
Raval Trial Law is committed to helping policyholders obtain their rightful benefits. We represent clients in Houston and throughout Texas who were wrongfully denied a health insurance claim or whose claims were unjustly delayed.
Though one may believe that their claims are covered by their insurance policy, the insurer benefits a great deal from interfering with the payout. For example, if an insurer wrongfully denies a health insurance claim, and the policyholder decides not to challenge the denial (and potentially recovering damages), then the insurer will effectively avoid a payout that they otherwise would have had to honor.
As health insurance providers are naturally in conflict with their policyholders, it is critical that policyholders take an active role in making sure their claims are fairly considered and processed by their insurance providers. If the insurer fails to act in accordance with their duties under the law, you should connect with an experienced Houston health insurance lawyer who can counsel you through the process of obtaining a favorable resolution.
Difficulties in having an insurance claim processed and accepted can be related to, but are not necessarily limited, to:
In some health insurance disputes, the policyholder may have failed to obtain pre-authorization from the insurer before receiving treatment. Failure to obtain pre-authorization may result in a claim denial, but the denial will not necessarily “stick.” If you can demonstrate that the treatment was necessary and would have been authorized by the insurer, then you may be able to successfully challenge the denial.
If you have had your health insurance claims wrongfully denied, delayed, undervalued, or otherwise interfered with by the insurer, it’s important that you connect to a qualified health insurance attorney with a track record of success in challenging the decisions of insurance providers and obtaining favorable results. Depending on the terms of the coverage, your attorney may have to re-file your claim, challenge the denial through an internal administrative process, and eventually file a lawsuit in court and take your case to trial.
When you consult with Raval Trial Law an experienced Houston trial lawyer at our firm will engage you in a collaborative partnership. We understand the unique challenges associated with insurance disputes, and how to navigate them successfully and in a manner that accomplishes our clients’ objectives. Our practical, results-oriented mindset drives every facet of our legal representation. We are laser-focused on working towards the best possible solution for each client.