Insurance Company Critical Illness Denial? Lawyers Can Help Appeal the Decision

Insurance Company Critical Illness Denial? Lawyers Can Help Appeal the Decision

Critical Illness Denial Lawyers


Being critically ill is difficult enough; trying to navigate the insurance system adds major stress to an already stressful situation. If you have a critical illness, but have had an insurance claim denied, you need to find an experienced personal injury lawyer. These lawyers know how the insurance industry works, and how exacting the paperwork and processes can be. Often when a claim has been denied, an experienced lawyer can appeal the decision, and have it reversed. A good personal injury law firm can help you during this tough time, and work to get you the benefits you deserve.

Why Was My Claim Denied?


First, you should understand that many claims are denied. Insurance companies, like any business, try to improve their bottom line. This means that they try to take in as much money as possible, and pay out as few claims as possible. You may think that because you have been paying an insurance company, that they are on your side and will work for you; this isn’t necessarily true. Sometimes claims go through relatively simply, but often times claims are denied. If the client gives up after having a claim denied, the insurance company will save money.


Sometimes claims are denied because paperwork is missing. Any medical claim needs to be backed up with all of the necessary forms and all relevant medical records: test results, specialists’ reports, and treatment plans. You will also need to prove that you have been following the recommendations of your doctors with regard to treatments and therapies.


And finally, your illness must fit the definition of a critical illness as defined by your policy. For example, to claim a heart attack, a certain set of conditions has to take place, including, in some policies, "the death of heart muscle due to obstruction of blood flow, that results in the rise and fall of biochemical cardiac markers to levels considered diagnostic of myocardial infarction, with certain very specific cardiac changes." So if you have a heart attack but it didn’t meet those conditions, your insurance company may deny your claim.


However, during the appeals process, a good lawyer can make your case for you forcefully. Many times the insurance company’s decision is reversed, and your claim is accepted.

Working With a Personal Injury Lawyer


Some people worry about hiring a lawyer during a time of illness, when money is already a concern. Personal injury lawyers, however, work on a contingency basis. This means that they won’t bill hourly, but instead will take a percentage of any compensation that you receive. Obviously, it’s in your lawyer’s interest to make sure that you receive the maximum benefits due to you.


In addition, most personal law firms offer free initial consultations with a lawyer. Look at law firms online, and find the ones that serve your area. Choose one that meets your needs. For example, if you are in a hospital and unable to travel, find a lawyer who will do that. If you are more comfortable communicating in a language other than English, look for a firm that offers services in other languages or translators.


If you have been diagnosed with a critical illness, don’t let the insurance company win. Critical injury lawyers are there to help with denials of claims. Contact a personal injury law firm today, and get the benefits you deserve.