Filing an insurance claim can be a complex and difficult process, especially knowing that many claims are initially denied. The reasons for denial can vary from case to case. However, it is important to consider why your claim may be denied, as you go through the claim filing process.
Reasons for claim denials
Here are a few of the most common reasons why your insurer may deny your claim:
- Lapse in policy coverage: The insurer may claim that an insurance policy’s coverage had lapsed or that a customer has been moved into a different sector of insurance.
- Errors during the claim filing process: Filing your claim too late or providing incorrect or incomplete information to the insurance company can result in a denial of your claim.
- Lack of medical necessity: Many accident victims undergo months of medical treatments and rehabilitation to recover from their accident-related injuries. These treatments are typically prescribed by the person’s doctor and are necessary for a full recovery. However, the insurance company may disagree and deny your claim after finding that the treatments you received were not medically necessary.
- Pre-existing condition: The insurer may also deny your claim after determining that your accident-related injuries and treatments were related to a pre-existing condition.
What are my options?
Insurance companies are supposed to be advocates for their clients, but unfortunately, they are also focused on making money. If an individual feels an insurance company has denied a valid claim, their main recourse is to file an appeal or sue the insurance company for breach of contract and fraud.
Fighting against major corporations that have vast legal resources can seem daunting. However, an insurance law attorney in Las Vegas who is experienced with claim denials can represent your best interests and make sure that you get the benefits you are entitled to