Health Insurance Claims and Insurance Bad Faith Litigation

Health insurance is a very important topic in this country today.

Most of us want affordable health insurance that provides extensive coverage when we or our loved ones get hurt or sick.

When we are sick and need medical care we expect our health insurance carrier will pay the medical bills.  But, this is not always the case.

Most policyholders do not know how to challenge their insurance company when health insurance claims are unreasonably denied. Who can you turn to for health insurance claims assistance?

Unreasonable Conduct by Your Health Insurance Company

If our health insurance company does not pay for our medical care, we get stuck with the bill.  With a serious illness these bills can easily run into the hundreds of thousands of dollars.

Sometimes health insurance claims are denied by insurance companies because you had to seek medical help outside of their network. Sometimes insurance companies deny health insurance coverage because of a pre-existing condition or some other problem.

Regardless of the reasons why your health insurance claim has been denied or underpaid, you should have your insurance company’s denial analyzed by insurance attorneys with experience with these types of situations.

For example, when medical benefits are denied under a valid heath insurance policy based on incorrect medical history information in the application, there must be an analysis of the health insurance application process and how the courts have dealt with that issue.

  • Was the health insurance application filled out by the applicant or the insurance company’s agent?
  • Was the applicant given a chance to read the health insurance application before it was signed; or did the agent place the application in front of the applicant and direct the applicant to sign without reading it?
  • Was the health insurance application filled out by a broker?

The case law generally imputes the conduct of the agent to the insurance company, but not the conduct of a broker.

The courts typically are inclined to rule against an insurance company that declines health insurance claims coverage because of a failure to include pertinent medical history in an application where:

  1. The health insurance application is taken and filled out by an insurance agent, and the agent does not read all of – or improperly reads – the questions to the applicant
  2. The health insurance agent is careless or intentionally fails to include all of the applicant’s prior medical history
  3. The insured informs the health insurance agent of pertinent medical history information, but the agent’s response to the insured is that the insurer would not be interested in such information.

These are just some examples.

Whatever the reason or your situation, if you have had benefits from medical insurance claims denied or underpaid, talk to an insurance bad faith lawyer with insurance experience.

Contact Experienced Bad Faith Insurance Litigation Attorneys

With over 60 years of combined insurance bad faith litigation experience, the principal lawyers at Viau & Kwasniewski can help you fight unreasonable insurance bad faith conduct by your insurance carrier.

Viau and Kwasniewski is a Los Angeles based law firm. We handle insurance bad faith litigation throughout the State of California.

If you would like more information about health insurance claims and how to fight insurance company bad faith, contact the law office of Viau and Kwasniewski for more information.

Our trial attorneys will work on a Contingency Fee basis in most cases, meaning we are paid only if we obtain a recovery for you.

Call Toll Free at 1-833-633-1095 for a free, no-risk initial consultation regarding your health insurance claims or email our insurance bad faith trial attorney or simply complete our online Contact Us Form.