Denied Insurance Claims Attorney

Challenging Bad Faith Denials in Insurance Claims

Our San Francisco, CA denied insurance claim lawyer knows that insurance companies carefully craft denials of claims to provide the appearance of validity and to discourage the insured from making a fair and justifiable challenge. However, when you put the insurer’s denial under the microscope, the denial often cannot be sustained.

When properly challenged, the insurer’s highly selective “review” of the medical and vocational evidence can be readily exposed. The medical and vocational “experts” whom, you are told in the insurer’s denial letter, support the denial are often revealed to be mere pawns of the insurer with whom they enjoy a longstanding and highly lucrative business relationship.

Many Insurance Companies Manufacture Pretexts To Deny Claims

Under California law, your insurance company must thoroughly investigate any basis that may support payment of your claim and cannot disregard evidence that supports your claim. However, insurance companies create pretexts to deny claims including, most commonly:

1. You have “no objective signs” or “no abnormality on exam” — even where your purported lack of objective signs or abnormality is irrelevant to why you are unable to work;
2. You are able to engage in “sedentary work” — even where your ability to sit has nothing whatsoever to do with why you are disabled from your job;
3. You fail to meet the “definition of disability” in the policy — even though the definition of disability in the policy, in fact, is illegal under California law;
4. Your own treating doctor has stated that you are able to work — where, however, your treating doctor was never informed of the correct definition of disability under California law and obviously an incorrect definition in mind;
5. Your own treating doctor does not support your inability to work — where, in fact, your doctor made an ambiguous statement about your working capacity that should and can easily be clarified — but your insurer elects not to do so and resolves the ambiguity in its favor.

When it comes to medical insurance, insurers commonly misconstrue key terms of the insurance policy such as “medical necessity” or “emergency care” to generate or buttress their denial of benefits. Medical insurers commonly assert inapplicable exclusions to deny your claim.

Bennett M. Cohen stands up for people whose insurance claim has been denied in bad faith. He will fight aggressively and effectively for you to recover the benefits you deserve.

What Are My Options If My Claim Has Been Denied?

If your insurance company has denied your claim or underpaid your claim, it is important that you seek counsel from an experienced insurance attorney. Once you know your rights under the law, you will be empowered to make the right decisions to obtain redress against the insurer.

At The Law Offices of Bennett M. Cohen, P.C. we represent individuals throughout California who have had their claims denied or benefits underpaid. Our San Francisco denied insurance claim lawyer has decades of experience successfully advocating for individuals whose benefits were unfairly denied due to the bad faith of insurers.

Understanding Health Insurance Claim Denials

If you have had a health insurance claim denied by an insurance company, a San Francisco, CA health insurance claim denial lawyer can help you. Health insurance is a critical safety net that provides financial protection when medical needs arise. It’s an assurance that, should health concerns emerge, financial coverage will be available. However, not all insurance claims are straightforward. Sometimes, insurance companies deny claims, leaving individuals grappling with medical bills they believed would be covered. These denials can arise from various reasons, such as discrepancies in paperwork, perceived non-covered treatments, or disagreements regarding the necessity of a medical procedure. No matter the circumstance of your claim denial, contact The Law Office of Bennett M. Cohen today to find out how we can help you with your claim.

The Importance Of Legal Representation

When facing a denied health insurance claim, the situation can seem daunting and, often, unfair. This is where a skilled San Francisco health insurance claim denial lawyer comes into the picture. Armed with the legal knowledge, experience, and a deep understanding of the intricacies of health insurance policies, a specialized lawyer can significantly increase the chances of overturning an unjust claim denial.

With a comprehensive approach that involves thoroughly reviewing insurance policies, evaluating the reasons for claim denials, and understanding the medical background of each case, having a good lawyer by your side ensures that every angle is covered.

The Role Of A Health Insurance Claim Denial Lawyer

The primary responsibility of a San Francisco health insurance claim denial lawyer is to serve as a bridge between the claimant and the insurance company. They analyze the cause of the denial and determine if it’s grounded in the terms of the policy or if there might be an overreach on the part of the insurer.

This process involves gathering information, policy review, negotiation, and, if necessary, litigation. Gathering information is the foundational step where all relevant documents, including medical records and correspondence with the insurer, are compiled. Policy review entails a meticulous analysis of the health insurance policy helps to understand its terms, conditions, and any fine print that might be relevant to the claim. Often, claim denials can be resolved without litigation. A seasoned health insurance claim denial lawyer can engage in negotiations with the insurance company, aiming to secure a fair settlement. In cases where a resolution cannot be reached through negotiation, the next step is to present the case in court. With a robust legal strategy and compelling evidence, a claim denial can be contested effectively.

Moving Forward With Confidence

Encountering a health insurance claim denial can be stressful and, for many, financially crippling. However, it’s essential to remember that a denial is not the end of the road. With the right legal representation, there’s a substantial possibility of overturning the decision and securing the benefits one is entitled to.

If you or someone you know is facing challenges with a denied health insurance claim, let the experienced team at The Law Office of Bennett M. Cohen support you through the process.