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Wrongfully Denied Insurance Benefits: Here’s What You Can Legally Do

It’s certainly tough being denied your insurance benefits when you know you are entitled to them. However, the good news is you do have options for appealing the decision. 

Here’s a look at what you can legally do.

 Contact a Lawyer if Your Insurer Wrongly Interprets the Evidence of Your Claim

An insurance company cannot legally deny insurance benefits when it’s proven that the insurer based the claim denial on false information. 

Suppose you believe you have received a claim denial on your long-term disability insurance because the insurer has wrongfully interpreted the medical and occupational evidence. In that case, you should speak to a Long Term Disability Lawyer straight away to remedy the problem. 

Insurance companies that provide short-term or long-term disability insurance will often investigate the validity of benefits claims, which includes conducting online investigations of the person’s social media accounts, helping them reach their decisions about claims. So, it’s no wonder that bad-faith claim denial is becoming more common. 

Whether you’re claiming for disability insurance or another type of insurance, make sure you tell the truth on your claim and submit the correct evidence to prevent your insurance benefits from being wrongfully denied in the first place. 

If your benefits are still denied, contact a seattle long term disability lawyer who can help you to receive the benefits that you are legally due.

Put Your Claim in Early to Avoid Deadline Issues

Another common reason for insurance benefits being wrongfully denied is that insurers believe you have missed your claim deadline.

All insurance policies have strict deadlines and procedures for filing claims, so if you miss the given deadline, you could lose your legal rights to the claim.

Always ensure you put your claim in by the due date. However, even when you do so, due to the time it takes the insurance company to process, there could be a lag in processing your claim. In turn, that could potentially mean your claim is marked as late by the insurer when it actually arrived on time.

While you can obtain the services of a lawyer to legally overturn the decision, the best thing to do is prevent the situation from happening in the first place. Don’t leave submitting your claim until the last minute.

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Appeal the Insurer’s Wrongful Denial

Whichever insurance benefits you’re wrongfully denied, and for whatever reason, you do have legal options to help you gain access to your rightful benefits.

Quite simply, if your insurance benefits have been wrongly denied, you have the legal right to appeal to the insurance firm.

While you can do that yourself, it’s best to hire a lawyer. That way, you stand a much better chance of winning your case.

Furthermore, lawyers typically only charge fees for winning cases and take their fees out of the money owed to you, so you don’t have to find any cash up-front.

The majority of insurance policies require you to first appeal to the insurance firm before taking the matter to court, and many insurers will want to settle out of court.

But bear in mind that you will usually have a limited time to appeal. A lawyer will know what the legal time period is for appealing.

He or she will also help with the things that need to be done before an appeal, such as requesting a copy of the insurance plan from the plan administrator, gathering evidence, and collecting additional information that helps prove your claim.

The insurance claim then needs to be carefully analyzed to identify any issues and errors on the insurance company’s part.

As long as you or your lawyer can prove that you have been wrongfully denied your insurance benefits, you will win your case.

Featured Image by LEANDRO AGUILAR on Pixabay