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Have You Experienced a Police Officer Denied Health Insurance Claim?
California police officers generally receive healthcare through their jobs. This coverage exceeds most plans offered by private employers. Even so, there can be times when a healthcare claim is denied. If the claim in question is for a procedure, test, or treatment that you need, there is no reason to allow the insurance company to get away with such a denial. As a police officer (public employee), you have the right to appeal internally, submit the claim for an external review, then bring a lawsuit against your healthcare provider.
Like teachers, and other public employees in the state, police officers obtain their healthcare insurance through their employers. Certain health plans are available only in specific counties or zip codes, with open enrollment in the fall. During open enrollment, you can enroll, delete, or add eligible dependents, change health plans, or cancel your coverage entirely. Some health insurance plans allow coverage to continue into retirement.
What Should You Do When You Have Experienced Police Officer Denied Health Insurance Claims?
If you’ve received notification that a medication your doctor prescribed, a test that will help diagnose an illness, a surgical procedure, or any other type of treatment has been denied, it can be extremely frustrating. When your doctor is telling you that you need a specific medical treatment and you are unable to pay for it on your own, it can be frightening, to say the least. It is important to remember that you do have the right to appeal an adverse decision—and that many appeals are successful. If your appeal is denied, you have the option of going to a third-party external review process. If that is unsuccessful, you can file a lawsuit against your insurer.
Appealing a denial of coverage can be time-consuming, not to mention overwhelming. Once you’ve received your Explanation of Benefits document, you will be able to know why the claim was denied. It may have been denied for something as simple as a form that wasn’t correctly filled out, or a miscoded procedure. If, however, your claim was denied because the insurance company does not consider the procedure, treatment, prescription drug, or surgery medically necessary, it is time to speak to attorney Scott Glovsky. You will experience much less anxiety once Scott is by your side as your advocate from start to finish
Are Police Officers Particularly Vulnerable to Insurance Claim Denials?
Police officers are not necessarily any more vulnerable to insurance claim denials than anyone else, but that’s not to say they don’t experience claim denials. If the treatment or service denied by your insurer was deemed not medically necessary or experimental, it is important that you take steps as quickly as possible.
Filing an appeal within 30 calendar days of the date on your denial letter may be critical to obtaining a reversal of your claim denial under some plans. If waiting on a standard appeal could cause serious harm to your health, you, your physician, or your attorney can request an expedited appeal. (If you have already received the medical care and are appealing a denial of reimbursement, an expedited appeal is not available).
As a Police Officer, What Should I Do if My Health Insurance Claim is Denied?
If your health insurance claim has been denied, contact the Offices of Scott Glovsky as quickly as possible. Attorney Scott Glovsky will first make sure that no time limits have been exceeded. He will then discuss your options with you, regarding filing an appeal. If you have already filed an appeal that was denied, Scott will explain the next best steps. A third-party external review may not be the route to take. As a public employee, you can file a lawsuit against your insurer to make it live up to the promises it made when you signed up with it. Scott will walk you through all the options, helping you determine the best course of action for your specific situation.
How Can an Attorney Help Police Officers with Health Insurance Claim Denials?
As a police officer and public employee, you are in a unique position when you receive a healthcare claim denial. This is due to the fact that you can sue for damages over and above medical costs incurred when a healthcare claim denial is received. Those additional damages could include such things as lost wages, pain and suffering, loss of income, and even punitive damages. Thanks to being in a non-ERISA—Employee Retirement Income Security Act of 1974 plan,—public employees have a guaranteed right to appeal a health insurance claim denial.
Attorney Scott Glovsky will assist you in submitting the required additional documentation that supports your request for a medical procedure, drug, test, or treatment. You will probably also include a letter from your doctor explaining the necessity of the medical treatment. Even if you are not successful in your appeal, you can file a lawsuit against your insurance provider. In some cases, simply filing such a lawsuit can prompt your insurer to pay your medical claim. The insurance company knows that if they lose a lawsuit, not only will they be responsible for paying the claim, but they could also be responsible for the damages mentioned above.
How Can the Law Offices of Scott Glovsky Help Following a Police Officer Denied Health Insurance Claim?
Attorney Scott Glovsky and his team are ready to help you through your police officer denied health insurance claim. Wherever you are in the process, we can help. Maybe you’ve already filed your appeal and been denied, or maybe you just received your claim denial. Either way, we understand your situation and we understand the devastation a medical claim denial can have on you, your family, and potentially your future. Your insurer promised to be there to protect you and your family members. When it falls short and denies your claim, Scott Glovsky is ready to fight for the justice you need and deserve. Contact the Law Offices of Scott Glovsky today.
