Los Angeles Kaiser Permanente Health Insurance Denial Lawyer

Kaiser Permanente is one of the largest healthcare systems in the country, operating hundreds of medical facilities and employing hundreds of thousands of people. Nearly twelve million people rely on Kaiser Permanente for health insurance and coverage.

With the ballooning cost of medical care, health insurance is an absolute necessity for individuals and families. Unfortunately, large insurance providers deny health insurance claims all too often, which can threaten a person’s health, livelihood, or impact their family.

It can be incredibly frustrating and scary to have a health insurance claim denied. Furthermore, the process of appealing a denial or filing a lawsuit against an insurance provider can be complex. If you have had a health insurance claim denied by Kaiser Permanente, a Los Angeles Kaiser Permanente health insurance denial lawyer could be an invaluable resource in helping you appeal a decision or file a lawsuit to recover for your damages and losses. Contact a skilled health insurance denial attorney that could advocate for you.

Why are Health Insurance Claims Denied?

Health care expenses have been cited as one of the leading causes of bankruptcy in the United States. In many cases, this can be directly correlated to a health care insurance claim being denied. Kaiser Permanente and other health management organizations often deny health insurance claims for the following reasons:

  • A service or procedure is not covered under the claimant’s policy
  • A procedure is considered experimental, cosmetic, or is intended for investigation
  • The procedure required a pre-authorization that was not provided
  • The services and/or healthcare provider selected is out-of-network
  • Administrative or typographical errors

Health insurance providers have a legal obligation to handle all health insurance claims in good faith. According to Gruenberg v. Aetna Insurance Co. (1973), if a health insurer such as Kaiser Permanente “fails to deal fairly and in good faith with its insured by refusing, without proper cause, to compensate its insured for a loss covered by the policy, such conduct may give rise to a cause of action in tort for breach of an implied covenant of good faith and fair dealing.”

When a person’s health insurance claim is denied, it could mean that they do not receive the medical care that they need. Alternatively, an insurance company may deny a claim after a service is already rendered, leaving policyholders struggling with massive bills.

What to Do If a Health Insurance Claim is Denied?

When Kaiser Permanente denies a health insurance claim, the claimant may appeal this decision. According to a report released by the United States Government Accountability Office, a majority of claims that are appealed are reversed in the consumer’s favor.

Appealing a health insurance denial requires understanding the complexities of medical insurance laws and the California Insurance Code, as well as how to navigate through Kaiser Permanente’s confusing appeals process. An experienced Los Angeles Kaiser Permanente health insurance denial lawyer could help guide individuals and their families through this complicated process and work to ensure their appeal is given the attention it deserves.

Fighting Kaiser Permanente Health Insurance Denials with a Los Angeles Attorney’s Help

If you believe your health insurance claim was unfairly handled by Kaiser Permanente, contact a Los Angeles Kaiser Permanente health insurance denial lawyer today. A seasoned attorney could help you and your family work to hold this large insurance provider to their word and potentially secure the benefits you deserve. Call today to schedule a consultation.