Fighting Insurance Claim Denials for Firefighters
As a firefighter, you want the health insurance coverage that you earn with your job to be there for you when you need it. If your insurance company is standing in the way of coverage, an Orange County health insurance claim denial attorney at Quincey Law can fight to ensure that you get the benefits you deserve.
The health insurance company is bound by strict California law that governs practically every aspect of their customer-facing operation. Not only can you push back legally to get the care that you need, but you may also take legal action against the insurance company to seek damages when they have broken the law. The insurance company does not get the final word about whether your claim is covered.
If you were expecting a health insurance claim to be covered, and it has been denied, speak to an Orange County health insurance claim denial lawyer by calling us at (866) 945-9175. We can review the facts and circumstances and help you determine your next steps.
You Need the Health Insurance Coverage You Have to Be There For You
Firefighters put their lives on the line for the public. One of the benefits that a firefighter rightfully receives from their employment is health insurance coverage. Unfortunately, these health insurance companies are often most interested in their profits and pleasing their shareholders. This can sometimes result in either wrongful business practices, illegally denied claims or both. As a public employee, the law favors you in allowing you to sue your health insurance company for bad faith if they have broken the law.
As a firefighter, you need to be in peak shape because you will need to quickly respond to calls that require physical exertion. You cannot afford to have your health insurance claims wrongfully denied because it can affect your health and your ability to work. Further, the stress of your job means that you do not want to take the time to fight with and engage the insurance company in what may already be a futile battle.
The Insurance Company Does Not Have Unlimited Power
If your health insurance company has wrongfully denied your claim, the first step is to understand the exact reason why they are not paying for your care. The law requires them to make the reasoning clear. Even then, you may not be satisfied with their explanation. At that point, it is up to you to take matters into your own hands. However, you may not have the confidence or knowledge to put pressure on the insurance company on your own.
Insurance companies can rely on perceptions of their power when they try to get away with denying the care that you need. California law makes it very clear that insurance companies are not omnipotent. The law allows you to do several things to both enforce your legal rights and to potentially take action against the insurance company if they have violated your rights.
Your immediate concern is to overturn the insurance company’s denial of your care because your health is paramount. You have the ability to file an appeal. If you choose to appeal, you must deal with the insurance company’s internal process. The insurance company is not known for taking a critical look at its own decisions, as the appeals process has earned the reputation of merely being a rubber stamp. Nonetheless, you may still try to persuade the insurance company to cover your claim.
You May Be Able to File a Bad Faith Lawsuit
You may also have the option to go through the legal system to fight to have your care covered. Then, you may also use the legal system to take direct action against the insurance company if they have broken the law. California law prohibits many of the tactics that insurance companies have been known to use. For example, insurance companies may not:
- Deny care that is clearly covered by the terms of your policy
- Unreasonably deny your claim without adequate investigation
- Unreasonably delay responding to your claim and giving you a decision
- Misrepresent the terms of your policy when they deny your claim
In some cases, insurance company tactics can rise to the level of bad faith. This is a legal term of art that is used to describe insurance company conduct that breaks the law. To be clear, not every denial of care is an example of bad faith. When the insurance company’s conduct meets that threshold, you may seek compensation directly from the insurance company, in addition to forcing them to cover your care.
Contact an Orange County Health Insurance Claim Denial Law Firm
If you are a firefighter, and you have been denied a fair shake by the insurance company, speak to an Orange County Health Insurance claim denial attorney at Quincey Law. You can schedule a free initial consultation by visiting our website or by calling us today at (866) 945-9175.