Received a Denial?
We Can Help. Contact A Long Beach Health Insurance Denial Attorney
According to Covered California, below are just a few of the California health insurance companies and their level of insurance denials:
- Anthem Blue Cross—2,671,617 claims received in 2020 (537,071 denied)
- Blue Shield of California—15,076,796 claims received in 2019 (4,952,371 denied)
- Kaiser Permanente—45,577 claims received in Northern CA in 2019 (3,333 denied)
- Kaiser Permanente—118,010 claims received in Southern CA in 2019 (7,848 denied)
If you are like most Californians, you probably went through quite a process when seeking the best insurer and policy benefits for you and your family. We do this to find the very best insurer for our specific health needs. So, when your health insurer denies your legitimate claim—or engages in delay and underpayment, you need the help of a Long Beach, CA health insurance denial attorney.
Scott Glovsky has dedicated his legal career to helping those with legitimate health insurance claims denied. Scott routinely takes on huge insurance companies, fiercely protecting his clients’ rights and futures. At the Law Offices of Scott Glovsky, we care about your health insurance denial issue. We go the extra mile to put the needs of our clients front and center. We will listen to you, support you, and make ourselves available when you have questions or concerns.
Since we only take cases we fully believe in at the Law Offices of Scott Glovsky; we will fight to expose wrongdoing on the part of the insurance company. We win our cases by finding the truth, then exposing insurance company deception. We are proud that we are always 100 percent prepared as we fight for you and for what we believe.
What are the Legal Duties of an Insurance Company?
Your healthcare insurer has the legal obligation to treat you fairly and to make decisions on your claims in a reasonable manner. When an insurer fails to act reasonably or fairly, this is known as acting in bad faith. When any of the following occur, your insurer may have acted in bad faith:
- Your valid claim was denied for no legitimate reason.
- Your insurance company failed to communicate with you properly.
- Your insurer intentionally misrepresented the terms and conditions of your healthcare policy or intentionally misrepresented the facts.
- While acknowledging a claim should be paid, your insurer continues to refuse to pay a portion of the claim.
- Your claim has not been adequately investigated.
- Your valid claim has been denied as a method of forcing litigation.
- Your valid claim has been delayed time after time.
Of course, not every insurance claim denial involves bad faith. In some cases, there are legitimate reasons your claim could be denied.
Why Do Health Insurance Claims Get Denied?
Health insurance claims are denied for many reasons, sometimes for something as innocuous as a form that is incomplete or improperly filled out. When something this simple is the reason for a claim denial, there is usually a simple fix. Other times, a claim may be denied because you have maxed out your plan’s coverage limits. Prescription drugs are sometimes rejected because they are not a part of your healthcare plan.
Other times, your insurance company may require you to take one or more cheaper alternatives before they approve payment for the actual drug your doctor prescribed. You may have used an out-of-network provider or service; therefore, your insurer denies your claim. Your health insurer may deem that a procedure, test, or prescription drug is not medically necessary—even though your treating physician believes it is.
What Tactics Do Insurance Companies Often Use?
The most common tactics used by insurance companies are known as the three D’s—Delay, Deny and Defend. Your insurance company may simply delay your claim, over and over—until you finally give up. Your insurance company may notify you that it needs you to fill out a form. Then it might tell you that you didn’t fill out the form correctly, you need to fill out another form, your claim is too late, your claim is not covered unless…and on and on and on. The insurance company knows that the more difficult it makes your claim, and the longer it delays, the more likely you will give up, even though your claim is perfectly legitimate.
If delaying tactics do not work, your insurer may next deny your claim. It knows that you may appeal its decision, but in truth, without an attorney, the appeal process can be complex and time-consuming. Since few of us have the knowledge or the time to follow the appeal process, many simply give up—just as they do from the delaying tactics. If delays and denials do not work, your insurance company may force you to defend your claim in court. This means there will be further delays—months or even years—while the issue is litigated. All the while, the money that would have been paid out on the claim remains in the insurance company’s bank account.
How a Long Beach Health Insurance Denial Attorney from the Law Offices of Scott Glovsky Can Help
Having a highly experienced Long Beach health insurance denial attorney from the Law Offices of Scott Glovsky can make a massive difference in the outcome of your claim denial. Attorney Scott Glovsky and his legal team work together to help individuals just like you dealing with an insurance company that does not want to do the right thing. Scott has been recognized as an award-winning Long Beach insurance bad faith lawyer and a nationally recognized advocate for the rights of insurance policyholders. We will approach your case with the understanding that the outcome could affect your life—both physically and financially.
When you have reached the end of your rope dealing with an insurance claim denial, we are ready to help. Scott Glovsky is a highly skilled, knowledgeable Long Beach, CA, health insurance denial attorney. Attorney Glovsky will be honest and straightforward with you, working hard to help you receive payment for your claim. The Law Offices of Scott Glovsky strives to help those who have been wronged, fighting fearlessly and aggressively for you and your family. Contact the Law Offices of Scott Glovsky today.