Suing a Health Insurance Company for Bad Faith

August 21, 2022

If your health insurance company is giving you the run-around concerning paying a large claim, you might think about suing the health insurance company for bad faith. “Bad faith” is a legal term for an insurance company going beyond bad service or making an honest mistake. It breaks the law in its dealings with you, cheating you out of the insurance benefits you’re paying for.

Doug Terry, a prominent figure among Oklahoma health insurance claim denial lawyers, represents those who’ve been denied insurance coverage through illegal actions by their carriers. He helps those with all kinds of insurance, including medical coverage. Healthcare, especially treatments for life-threatening and chronic conditions, is costly. Few of us can afford to pay for it ourselves, which is why we have health insurance. Doug Terry knows how to file a lawsuit against a health insurance company and what it takes to win.

There’s a wide range of medical coverage available. Your policy may be very comprehensive or not be of much help, so it makes sense to get as much coverage as you can afford. The reality may be that the company has no obligation to pay for what you want covered.

Before You Sue a Health Insurance Company, an Internal Appeal May Be Worth a Try

If you have a denied health insurance claim, you may use an internal appeals process. Given the costs of a particular treatment and how much you need it, it may make sense to get Doug Terry’s help if you take this step.

We will review your policy, gather the medical records and information to support your claim. Our office will write the appeal and put together a package of supporting material. This is time-consuming work that’s better done by someone who knows the ins and outs of this area of law.

Doug Terry knows how to write an appeal that will get attention. It may convince the company that covering your type of claim is why you pay premiums. You’re not asking for favors or a gift. You just want the company to live up to its end of the bargain.

Can I Sue My Health Insurance Company for Taking Too Long?

If you or a family member is facing a medical crisis, there’s no time to waste. Instead of a denial, you may get a delay. Instead of focusing on your health and recovery, you’re tangled up in insurance red tape.

The medical procedure may be a matter of life or death. You may not have time to spare before the procedure becomes more complicated or less likely to succeed. Under Texas law, health insurance carriers are obligated to decide coverage requests within a reasonable time.

Suing Health Insurance Company for Bad Faith May Be Your Last, Best Option

If an internal appeal doesn’t work and the insurance company refuses to cover your claim, a “bad faith” claim may be an option. If your insurance company unjustly denies your claim or unreasonably delays a decision, it may be time to file a lawsuit.

An insurance policy is a contract. In exchange for your premiums, the company promises to pay for your healthcare, with limitations. You don’t have any power to tell the company you want something added or removed from the policy.

Without the ability to sue for bad faith, you may be at the mercy of a dishonest insurance company who controls the evaluation, processing, and denial of your claims. If you could sue only for breach of contract, if you won, you’d only get the coverage you paid for.

For a successful bad faith claim when you sue a health insurance company, we need to show that the insurer had no reasonable basis for denying or delaying paying the claim. As an Oklahoma City bad faith insurance lawyer, we would need to prove it knew, or should have known, it was reasonably clear that the claim was covered, according to the state Supreme Court.

With a winning bad faith claim, if it’s shown that the company intentionally or knowingly violated the law, you may be awarded up to three times what the carrier would have paid you if it had acted properly. Attorney fees, interest, and court costs are also available.

You could be compensated for the mental anguish you endured because the company mishandled your claim. Punitive damages could also be awarded in a case of extreme wrongdoing.

• In most cases, compensation for mental anguish damages requires direct, detailed evidence of the nature, duration, and severity of your suffering. There must be a substantial disruption in your daily routine
• A finding that the insurance carrier acted in bad faith isn’t enough to justify a punitive damages award. These damages are meant to punish the company for its actions, and discourage it, and other companies, from taking the same acts in the future. It must be shown that the company’s conduct was malicious, intentional, fraudulent, or grossly negligent and that it was aware its action would probably cause you extraordinary harm such as death, serious physical injury, or financial ruin

How to File a Lawsuit Against a Health Insurance Company? Contact Doug Terry.

Deciding to sue a health insurance company is a serious step, but it may be an option you need to consider. If your carrier is denying or delaying your coverage beyond what’s reasonable, it’s time you talked to Doug Terry.

If there’s too much at stake for you to move on, we can discuss your situation, provide you guidance, and suggest your next steps. If you decide to retain our services, we will start building your case, putting our years of experience in handling bad faith insurance cases to work for you. Contact our office today by calling 405-458-5978 to schedule your free case evaluation.