If you have been trying to recover from a serious health diagnosis, you are probably aware that time is of the essence. Having your health insurance company deny a claim for a necessary procedure can be disheartening as you go through this difficult time. Your doctor may want you to start a specific treatment immediately. Since most medical conditions tend to get worse without treatment, any delay can make a huge difference in your eventual outcome. You may find yourself asking, “Is suing a health insurance company for taking too long allowed?”
The answer to this question is complex, but California health insurance providers are bound by state law to respond to claims within a specific amount of time. If they fail to do so, you may have the basis for a lawsuit against your insurer due to bad faith. At the Law Offices of Scott Glovsky, we fully understand the need for a quick decision. Perhaps your doctor wants to start you immediately on a treatment that could potentially save your life, but your insurance company is dawdling in approving or denying the claim. If you find yourself in such an untenable position, attorney Scott Glovsky can help.
Healthcare Providers are Bound by Law to Respond to Claims Promptly
The California Code of Regulations requires healthcare insurers to respond to recognize a claim within 15 days, approving or denying the claim within 40 days. When these time limits are violated, the insurer may have violated California law. Unfortunately, many companies are a bit more subtle as they delay claims to avoid payment ultimately. You could be told that a form you submitted never made it to their office or that they are waiting on a written opinion from your doctor—even though they have told you the opinion was sent. Any time such tactics are used as a means of not paying your claim, the insurer may be guilty of bad faith. In turn, this may qualify you for monetary damages because of this bad faith.
Has Your Insurer Failed to Act “Reasonably Promptly”?
Under California Insurance Code Section 790.03, when insurers fail to act “reasonably promptly” in response to member communications regarding processing or settling claims, they could be guilty of bad faith. Having a highly skilled bad faith lawyer by your side can make a huge difference. An attorney from the Law Offices of Scott Glovsky will thoroughly investigate your case, seeking evidence to back up your right to a treatment or procedure. We will then seek monetary damages for your insurer’s bad faith when delaying a response to your claim.
What You Should Do When Your Insurer is Not Acting in Good Faith
If you consider suing a health insurance company for taking too long, contact the Law Offices of Scott Glovsky. We have offices in Claremont and Pasadena, meaning we help clients in LA County and across California. Scott Glovsky is nationally recognized as a strong advocate for the rights of the injured and the insured denied benefits. At the Law Offices of Scott Glovsky, we help those in need of critical medical treatments and procedures who are facing injustice. Contact the Law Offices of Scott Glovsky today!
