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denied insurance claims Archives

Understanding insurers' long-term care claim denials

Many elderly people need assistance with daily tasks as they get older, and this is especially true if the individual in question suffers from memory loss or other health problems. Long-term care is the right solution for many families, but it can be prohibitively expensive. According to the U.S. Department of Health and Human Services, it can cost as much as $205 a day to stay in a nursing home.

Understanding national and local coverage determinations

While the care that you can expect to receive from any of the hospitals and clinics in Jacksonville is among the best in the world, it may come at a step price. That may be why receiving a denial notice from your health insurance company can be so disheartening. One of the more common reasons why medical claims are denied is because insurers deem that the procedures performed were not medically necessary. Here at Tyler & Hamilton, P.A., we’ve had several clients come to us wondering if such a decision can be appealed.

Common reasons for homeowners insurance claim denials

Many homeowners in Jacksonville purchase insurance for their properties because it provides them with peace of mind and financial protection against covered unexpected events. They pay their premiums faithfully, not aware that their insurers are only bound by law to cover claims if they are legitimate. Insurers have strict criteria in place that they use to help disqualify claims for payment. These requirements are often the very reasons why some homeowners’ claims are denied.

What do you do if your business insurance claim is denied? Part 1

Business insurance is one of those lifesaving decisions that can rescue a business from ruin. Unfortunately, there is one more obstacle between you and reconstructing your business – the insurance company. You probably assume that you file a claim and it will be approved in a matter of days, if not weeks. Unfortunately, your insurer only makes money if you pay premiums and never pays out claims. This creates a perverse incentive sometimes to deny valid claims.

Bad faith set-ups discussed

Bad faith insurance results when the insurance company wrongfully denies an insurance claim. Bad faith insurance suits can arise in the context of any insurance policy, including property insurance. Florida law created liability for insurers who act in bad faith in denying insurance claims. This post will go over bad faith insurance and what duties you are under to ensure your right to pursue compensation.

How to appeal if your homeowner's insurance claim is denied

Insurance companies routinely deny or lowball homeowner's insurance claims for all kinds of reasons, and if you have ever been on the receiving end of such an action, you know just how devastating such news can be. If your homeowner's insurance claim is denied following a burglary, hurricane, flood or another type of weather-related event, the costs associated with the damage can be staggering. While you have a right to appeal the decision, it is essential that you document the damage and closely familiarize yourself with both the policy itself and the specific details of your case.

Common reasons that auto insurance claims are denied

Auto insurance is intended to protect you and other motorists on the road if there is an accident. Typically, insurance will kick in to cover damages caused during an accident that was your fault. This includes property damage and medical bills if the other motorists involved undergo medical treatment. At times, your insurance claim may be denied, and you might be left wondering what protection it really offers. To prevent these situations, it's best to understand why insurance claims may be denied.

What do you do if your car insurance claim is denied?

Insurance companies depend on a simple business model; they need to take in more premiums than they pay out to their clients. This provides two incentives. First, insurance companies try to pick up as many paying customers as possible. Second, insurance companies minimize the amount and how often they pay out insurance claims.

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