Hospitalization Insurance Claim Denial: Medical Necessity
The last thing a person battling illness wants to hear is "your insurance claim was denied." Sadly, this is becoming a more common occurrence with our present day economic and health care situation.
A growing trend in the insurance business is to deny hospitalization claims on the basis that the medical service performed wasn't found to be "medically necessary." This could be a health insurance policy, accident insurance policy, hospitalization policy, disability insurance policy - or any other type of insurance policy purchased to cover medical services in the event of illness or injury.
The medical necessity provision in many policies is often misused by companies to deny valid and legitimate claims. But where does this lead? This puts the patient, who is already likely dealing with some income loss due to their illness, in an even more dire financial situation, as the insurance company (that they've paid month after month, year after year) makes off with their money without living up to their end of the bargain, and without paying for the hospitalization coverage they promised.
Insurance companies have a responsibility to do what they claimed that they would do when they sold you your insurance policy. Don't let them get away with denying your hospitalization coverage without discussing your case with an experienced insurance attorney.
Legal Recourse for Insurance Claim Denials
If you're legitimate insurance claim has been denied, you may be entitled to financial compensation for:
- medical services rendered
- hospitalization
- pain and suffering
- lost wages
- punitive damages (damages awarded to punish the insurance company for bad faith business practices)
Insurance attorneys at Kershaw, Cutter & Ratinoff make it their business to go after unscrupulous insurance companies who deny legitimate claims. They have enjoyed years of success litigating bad faith insurance claim denials, and they have the resources to go against even the toughest insurance companies. Read more about our history of making insurance companies pay.
Sacramento Insurance Lawyers Investigate Hospitalization Insurance Claim Denials
If you've been denied an insurance claim based on the "medical necessity" clause, we would like to hear from you. Email us, fill out the contact form at the right, or call us toll free at 888-285-3333 for a free and confidential case evaluation.