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Insurance Denials/Bad Faith Information, News & Blogs

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Who Decides What Is Medically Necessary?

One of the most common reasons health insurance providers give when denying a claim is that the requested procedure or treatment was not “medically necessary.” Cosmetic procedures or other elective treatments are typically excluded from coverage for this reason. In many cases, however, a treating physician will recommend a procedure or referral to a... Read More »

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When Can a Life Insurance Policy Deny My Claim?

Life insurance companies are always looking for a reason to deny claims or limit payouts. Do not be fooled, however: There are very specific reasons for which an insurance provider can deny a claim, and the reasons available depend in part on how long the policy has been in place. If your life insurance... Read More »

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Steps to Deal with an Unreasonable Insurance Company

Insurance companies will often use every means available to them to delay, limit, or avoid a payout entirely on a policy, regardless of the validity of the claim. They might stall their investigation, issue unreasonable document requests, offer you a lowball settlement, or drag their feet in issuing a payout. When your insurance company... Read More »

Class Action Lawsuit Filed Against Insurance Company for the Alleged Wrongful Denial of Medical Coverage

The law firm of Gianelli & Morris has filed individual and class action complaints against UnitedHealthcare of California alleging the wrongful denial of coverage for the Coflex medical device to treat the plaintiffs’ spinal stenosis and back pain. On November 4, 2020, the California insurance law firm Gianelli & Morris filed individual and class... Read More »

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How to Fight a Medical Necessity Bad Faith Claim With a Non-ERISA Policy

Sometimes it seems that health insurance companies care first and foremost about their bottom-line and are always on the lookout for any reason to deny a claim for coverage. One of the more common reasons for denial of a specific claim is “lack of medical necessity.” Continue reading to learn how to contest a... Read More »

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Does Life Insurance Cover Suicide?

We’ve all seen it on television or otherwise heard about it in pop culture: A person desperate to help their family takes out a large life insurance policy and then commits suicide in order to trigger payment, but the claim is denied as fraudulent. Or a person commits suicide and the family, already devastated,... Read More »

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How Can a Life Insurance Company Deny Your Claim due to Lapse of Coverage?

Life insurance companies, like all insurance providers, are constantly looking for any reason to limit a payout or deny a claim. If they cannot find a justification under the language of the policy to deny a claim, they might look for a reason to invalidate the policy itself. They may point to the life... Read More »

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How Life Insurance Companies Deny a Claim Using Material Misrepresentation

Life insurance companies will grasp at any reason they can find to deny a payout under one of their policies. If they can find a coverage exclusion, they will use it. If there is no exclusion, the insurance provider may utilize other strategies to avoid paying out on a claim, including by claiming that... Read More »

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What Should I Do if My Insurance Company Rescinds My Policy?

Insurance companies have a deep bag of tricks to pull from when trying to get out of paying out on a claim. In some instances, rather than deny a claim on the merits, the company may inform policyholders or beneficiaries that the policy itself has been “rescinded.” Like a claim denial, a policy rescission... Read More »

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Can I Sue my Health Insurance Company for Pain and Suffering?

When your health insurance company wrongfully denies coverage, the denial hurts more than just your wallet. You are effectively prevented from getting the treatment that you need for your illness or injury. You could end up having to pay out of pocket, or you may be forced to forego treatment entirely. If your claim... Read More »

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