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denied insurance claims Archives

Why are health insurance claims usually denied?

You expect your insurance company to cover the medical care you need to stay healthy. However, claims are often denied, and it can be stressful trying to get to the bottom of a rejected claim when you’re not entirely sure what went wrong. Knowing why denials happen is useful in this case and Nerdwallet.com offers a few reasons why your health insurance claim may not be approved.

What should you do if your insurance claim has been denied?

You are still recovering from a violent motor vehicle accident in Florida. Fortunately, you survived and are making progress in your healing. However, you are also still dealing with the lingering consequences of your crash including a damaged vehicle and mounting medical bills. To worsen matters, you recently discovered that your insurance claim has been denied. What are you supposed to do now? Understanding your options may allow you to come up with an alternative plan as you continue to recover from your accident. 

What Can I Do If My Insurance Claim Is Denied?

When making a home insurance claim in Jacksonville, you expect the insurance company to work with you, so you can get the help you need to repair your home. However, claims are often denied, and it can be difficult for a homeowner to work out the next steps when faced with a rejection. FoxBusiness.com offers the following advice in the event you’re faced with a denial and aren’t sure what to do next.

What are some reasons a water damage claim may be denied?

Water damage is one of the most confusing aspects of homeowner's insurance for many people in Florida. Some types of damage are easily approved claims, but others are often denied. It is important for you to understand what claims your insurance will cover, so you can make sure you are properly insured for all possible events. 

How much time do insurers have to approve a claim?

When disaster strikes, Florida homeowners may feel a great sense of relief just getting an insurance claim filed. The hard part’s over, right? Maybe not. Waiting is hard too, especially when you are waiting for a claim approval so you can get your life back to normal. As the days pass, you may experience growing frustration and begin to wonder if you are ever going to see a check in the mail.

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.

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