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denied insurance claims Archives

Judge sides with hospital in dispute with insurer

While most in Jacksonville likely value the assistance their insurers offer, they also may understand that insurance companies are businesses, and that businesses typically do not remain in operation by giving away money. Thus, the idea that insurers may constantly be on the lookout for loopholes that allow them to deny or reduce coverage may be more of a fact than a notion. Yet it should be remembered that despite their efforts to save money, insurers are obligated to provide coverage and reimbursement according to the promises made in the contracts they have with their clients. 

What steps should I take for a denied claim?

Living in the Sunshine State means the threat of intense weather is a way of life for most Florida residents, making the proper homeowner's insurance an imperative part of planning. However, what do you do when a catastrophe strikes and the insurance company denies a claim that you were certain was covered? According to the National Association of Insurance Commissioners, you have options to explore before blindly accepting the decision.

What to do if your insurance claim is denied

Florida homeowners, like other homeowners throughout the U.S., forego filing insurance claims for minor items, such as a broken window or damaged storm door, because they know their premiums might be raised. When they do file a claim, it is for something significant, and they expect it to be approved. When they receive a letter from the insurer denying the claim or fail to hear anything at all, they are understandably puzzled, to say the least.

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.

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