Health Insurance Benefits
You have health insurance because you want to offset the financial risk of needing expensive medical treatment. When that need arises, and your insurance company denies your claim, you can be left in a challenging financial position.
Chronic health problems, substance abuse issues, eating disorders and other chronic mental health conditions are just a few of the areas where health insurance companies frequently refuse to pay for recommended treatment.
Almost any health condition can lead to an improper denial of benefits. In all cases, it is important to know your rights.
At Wrobel & Smith, PLLP, our attorneys have extensive experience with health insurance concerns. They have more than 40 years of combined practice experience. Together, our legal team helps clients secure the health insurance benefits they deserve.
Understanding Your Coverage
You should not assume that your claim for benefits was denied for a valid reason. Insurance companies make mistakes and, in some cases, they even deny valid claims. Also, insurance contracts are dense and difficult to understand. Some even argue that those contracts are vague and confusing by design. Few people outside of the industry have the training to fully understand them.
At our firm we work with our clients to overcome the confusion in their insurance disputes, helping them understand their policy benefits as well as any possible limitations. By answering your questions carefully and correctly, we can work with you to improve your chances of getting a positive outcome.
Effective Health Insurance Advocacy
If you have been denied insurance coverage, you have rights. Keep in mind, that insurance appeal rights vary from policy to policy. That is where our substantial experience working closely with clients to understand their rights and options becomes especially valuable. We vigorously advocate on behalf of our clients to reach a resolution during the informal appeal process and pursue litigation when in the best interest of the client.
Taking Control of Your Claim, Wherever It Lands
Our goal is to help you move forward with your dispute and your life. The road we take to get your treatment approved and paid for depends on several things, though.
If your claim has been denied, your policy may allow you to appeal the decision in an informal process. If that isn’t possible, we may need to file a lawsuit to protect your rights. Such a lawsuit may fall under state or federal law, depending on your health plan.
Many employer-based health plans are governed by the Employee Retirement Income Security Act (ERISA). Our firm can help you seek the benefits you have rights to in any situation.
Regardless of which laws are at play or which court your case lands in, you can rest assured that we have the experience and skill to handle your claim from beginning to end.