ERISA Disability Claims: Navigating the Complexities of Federal Law
February 4, 2025
The insurance claims process, in all situations, can be overwhelming. That said, managing ERISA claims can be particularly challenging. Because of the federal regulations governing them, there are strict legal requirements that must be closely followed. The combination of the volume of detailed documentation required and the non-negotiable filing deadlines are only the start. Those who have fallen ill or become injured must provide specific criteria to prove their disability. Adding insult to injury, insurers tend to fight these claims vigorously. When it comes to getting the ERISA settlement you so desperately need, you, the injured party, become responsible for proving your disability. Undertaking this task on your own is not advisable. The process is intentionally complicated, and even the smallest m... Read more
Denied for a Pre-Existing Condition? Know Your Rights Under the Affordable Care Act
January 29, 2025
Take Action When Your Health Insurance Claim Is Denied Have you received notification from your health insurance company that your claim was denied because of a pre-existing condition? If so, you are likely experiencing a host of emotions. First, you may be frustrated. After all, when your claim was submitted you were under the impression that your pre-existing condition was covered. Second, you may be aggravated, especially because you submitted your claim in good faith and in accordance with your plan’s requirements. And, finally, you are likely concerned about the impact of this denial on your financial well-being. You have already invested in your health by paying your insurance premiums in a timely manner. It is reasonable to expect your covered claims to be paid. An insurance claim deni... Read more
Unreasonable Delays? What to Do When Your Insurance Company Stalls Your Claim
January 20, 2025
Delayed Insurance Claim Payments Are Unacceptable Do you find yourself checking your mailbox daily for your insurance claim payment that is late? If so, you are like many others in Oklahoma and across the country in asking the question, “Why do insurance companies delay claims?” Sadly, this issue is a regular occurrence: thousands of people deal with uncooperative insurance companies on a regular basis. Individuals in this position find themselves dealing with a host of emotions and issues, all of which are valid. First, they are frustrated with the process, which seems more complicated than necessary. Many have paid their premiums on time and submitted their covered claim in accordance with their carriers’ requirements. It seems reasonable to expect their claim be paid in a timely manner. That be... Read more
Grounds for Denial: Common Reasons Why Insurance Companies Refuse to Defend
January 12, 2025
Insurance Company Actions Are Often Surprising Insurance companies regularly refuse to provide defense services for policyholders facing legal action. This leaves these individuals both confused and fearful for their future. Facing legal battles alone and being forced to engage private counsel is costly. Many in this position ask, “Am I not entitled to receive this service from the organization from which I purchased my policy?” If you are facing a refusal to defend, understanding the reasons behind the denial is a crucial step in moving forward. You need to comprehend the facts in order to respond appropriately. This can be a challenging process, one best undertaken with the guidance of an experienced and knowledgeable insurance attorney. Researching and engaging representation is the first s... Read more
Reservation of Rights: What Does It Mean When Your Insurer Issues This Notice?
January 6, 2025
Yes or no, black or white, true or false? Life consists of choices and decisions. While some are straightforward, others are less so. This is particularly true when it comes to insurance claims. In fact, not every claim submitted is immediately paid or denied. In fact, insurance companies in Oklahoma and across the nation respond to many claims with reservation of rights letters. In general, these are notifications of indecision. But not everyone recognizes why this documentation is sent, what it means, or how to react. In fact, these letters may be a red flag indicating that your claim may, in fact, be denied. If you have received a reservation of rights letter you should consider speaking with an Oklahoma insurance dispute lawyer. Their perspective on your situation can guide your actions and he... Read more
ERISA Claims: What You Need to Know If Your Health Plan Is Through Your Employer
December 22, 2024
Managing Your ERISA Claim Can Be a Formidable Process Do you have insurance through your labor union or private sector employer insurance plan? If so and you have become ill or even disabled due to a serious illness or the impact of an injury, you may be able to file an ERISA claim for benefits. As you are well aware, the cost of medical care can be considerable, and these expenses are only the tip of the iceberg when considering your future. If you are disabled or so seriously ill that you are unable to return to work for a period of time or permanently, the financial impact on your life can be devastating. You may have coverage that can help alleviate these expenses. Unfortunately, filing, appealing, and litigating ERISA claims and obtaining the benefits to which you are entitled can be challen... Read more
Denied for a ‘Technicality’? Don’t Let Your Insurance Company Hide Behind Fine Print
December 15, 2024
Details, details, details!! If you have received an insurance claim denial, you are likely well aware that the reasoning behind their refusal to pay may not be based on something major. Often, it’s the little things, the small issues we refer to as ‘technicalities.’ Unfortunately, even seemingly minor technicalities can result in an insurance claim denial, placing the financial burden of treatment or services on you. These expenses can be financially devastating and, ultimately, life changing. If you have received a denial letter from your insurance carrier due to a supposed technicality, it can be worthwhile to engage the assistance of an Oklahoma denied claims attorney to assist with your appeal. Insurance policy language is complex, as is insurance law. Working with an experienced and ... Read more
How to Appeal a Health Insurance Claim Denial
December 3, 2024
Knowing how to appeal a health insurance claim denial is essential. Accepting your insurance company’s decision as final leaves you responsible for the cost of your treatment. In Oklahoma policyholders have the right to both an internal appeal and an external review if the insurer’s decision is not in their favor. If your claim has been denied, navigating the appeals process can be overwhelming. Engaging the assistance of a seasoned health insurance claims denial attorney can be valuable. Fighting a Health Insurance Claim Denial Has your health insurance claim been denied? If so, you should contact an Oklahoma insurance claim lawyer experienced in the appeals process. Engaging the knowledge and experience of an attorney can be the difference between success and failure for your appeal. Working wit... Read more
Time Limit for Appealing Denied Insurance Claims
November 15, 2024
You may have heard it said that time is a valuable commodity. This is true in much of life; you always want to be able to leverage time on your behalf. That said, in some instances it is particularly important . . . like when you have received a denied insurance claim notification. Being told your insurance company is refusing to pay your claim is concerning. Because you will not receive the coverage you expected, you may find yourself responsible for your costs (or even unable to get the treatment you need). This can negatively impact your finances, both today and in the long-term, as well as harming your health and well-being. During times like this, engaging an Oklahoma denied claims attorney may be in your best interests. This professional not only understands and appreciates the filing deadlines,... Read more
Denied Insurance Claims: A Delay Tactic Used by Insurers
November 5, 2024
The Problem of Delayed and Denied Insurance Claims Insurance companies deny many claims even though they know they will end up paying them in the long run. Unfortunately, delayed and denied insurance claims are a common problem faced by many in Oklahoma and across the country. Individuals purchase their insurance policies in good faith; they believe their claims will be paid completely, in accordance with policy language, in a timely fashion. Unfortunately, this is not how the insurance industry operates. In an effort to maximize profitability by minimizing expenses, insurance companies throughout the state regularly deny claims either hoping their policyholders accept their word as final or to gain the financial advantage of holding onto the monies owed longer. Multiple problems occur when insurance ... Read more