When to Hire and How to Find Lawyers for Health Insurance Claims

Considering hiring lawyers for health insurance claims? Having a health insurance policy should give you peace of mind. Unfortunately, not all health insurance companies have your best interests in mind. Some companies act in bad faith, denying what is rightfully policyholders’.

Navigating a health insurance policy is headache-inducing already. Having to deal with a company that acts in bad faith makes it worse. What can you do in such circumstances? You can hire lawyers for health insurance claims in UK.

The question is, when is the time to hire a lawyer to represent you? Also, how to find lawyers for health insurance claims? No worries. We are here to help. In this post, we tell you the answers to these questions and more.

Know the Reasons for Health Insurance Denial


Before you start searching for lawyers for health insurance claims, the first thing you need to do is to know the reasons for health insurance denial.

Health insurance companies are obliged to provide policyholders with a written explanation stating why it denied the policyholder’s claim for testing, treatment, procedure, or other medical services.

Common reasons why health insurance companies deny claims include

  • errors in the claim form with the patient’s information or diagnosis
  • the treatment in question lacks pre-certification or authorization
  • the treatment is provided by an out-of-network healthcare provider
  • a finding that the care in question was not medically necessary
  • a determination that the medical treatment was experimental in nature
  • filing a claim too late

How Do You Fight Health Insurance Claim Denial?


When your health insurance claim is denied, you can’t file for a lawsuit right away. Lawyers for health insurance claims may be able to help you but oftentimes, you must exhaust your health insurance plan’s appeals before you can file a lawsuit.

Also, keep in mind that your plan has specific time limits for submitting an appeal. How long or short the time limits vary from one plan to another. So, be aware and mindful of the deadline. If you fail to submit your appeal within the time limit, you may not be able to file for a lawsuit.

When to Hire Lawyers for Health Insurance Claims


You have a large or complex case

One of the most common reasons why policyholders hire lawyers for health insurance claims is because they have a large or complex case that they might not be able to win on their own.

1. You want to save time

Another common reason is to save time. Having to deal with a health insurance claim takes a lot of time. If your time is better spent earning money, taking care of your family, or doing other activities, hiring a lawyer can help to save time.

2. You need care, but what you are getting is a runaround from your health insurance company

When your health insurance company denies a request for care, you have several options. You can appeal to your insurer’s decision. Your insurer will then review the decision to see whether it is appropriate.

If your appeal request results in the same determination, you can ask lawyers for health insurance claims if your insurer is acting in bad faith.

3. Your healthcare insurance company terminated your insurance policy without reason

Unfortunately, this is a quite common scenario. A policyholder receives medical care only to learn that their insurer terminates their plan without their knowledge. Consequently, the responsibility for those medical bills falls entirely on them.

If a health insurance company terminates an insurance plan unjustly without proper notification, it may be violating the law. Lawyers for health insurance claims can help review the situation and determine whether the termination was warranted.

4. You received a delay, denial, or reimbursement underpay

Oftentimes, insurers will deny requests for care. These denials are given for various reasons. From out-of-network healthcare provider, experimental or investigational, to the care deemed not medically necessary.

Regardless, lawyers for health insurance claims can help determine which actions that your insurer took are legal and which actions are taken in bad faith.

How to Find Lawyers for Health Insurance Claims


Finding the right lawyer is not easy. Here are some ideas that can help you find the right lawyer to represent you in your case.

1. Talk to family or friends

One of the first things to do to find the right lawyer is to talk to people you trust. Ask your family members or friends who have had to hire a health insurance lawyer.

If they have a bad experience with a lawyer, they will not give you a bad recommendation. They will gladly tell you who to avoid. Likewise, if they have a good experience, they will tell you about it. Either way, talking to family or friends is a good start.

2. Talk to legal professionals to get a recommendation

If you don’t have family members or friends who have been involved in a legal dispute with a health insurance company, the next best thing to do is to talk to legal professionals. Ask for a recommendation from a lawyer who you trust and who has helped you in the past, for example.

3. Do an online search

Going online is certainly a good idea. Do an online search and find out health insurance lawyers in UK. Take your time to learn their background, including the education they have, previous experience with health insurance claims, etc. Reading online reviews can help, too.

4. Have a consultation with a health insurance lawyer

If you have lawyers that you are planning to work with, have a consultation with them. Ask questions and get to know them. See if they can represent you.

Ideally, a health insurance policy should give you peace of mind. The problem is, not all health insurance companies have policyholders’ best interests in mind. In such cases, hiring lawyers for health insurance claims can help you get what is rightfully yours.

Before hiring a lawyer, make sure that you know your insurance plan and your rights. Consider your circumstances as well. If you take your time and do your due diligence, you can rest easy knowing that you found the right lawyers for health insurance claims to represent you.