Fighting Insurance Claim Denials for Sheriffs and Sheriff’s Deputies

Serving the public in the capacity of a sheriff or deputy does not get you any extra goodwill as far as your health insurance company is concerned. If your claim has been unreasonably denied, the California health insurance claims denial attorneys at Quincey Law can help you hold the insurance company accountable.

California law applies to public employees the same as it does to any other workers. In addition, there is a carve out from relevant federal law that could allow you to take action directly against the insurance company as a public employee. The insurance company does not get the final say, and they can even be made to face justice if they have taken things too far.

To learn more about the process for fighting a denial, schedule a free initial consultation with the health insurance claims denial lawyers in California at Quincey Law by calling us at (866) 945-9175. Our driving purpose is to help individuals get a fair shake when they are dealing with large companies that are not following the law.

Sheriffs and Deputies Must Deal with Insurance Companies

As a sheriff or sheriff’s deputy, you receive your health insurance through your job. The individual department that you work for has likely negotiated a contract with the union that represents you through the collective bargaining process. This contract provides that you would receive certain benefits as a condition of your employment, including health insurance.

You must deal with the same insurance companies whose practices seem to bedevil other California residents who do not work for the state. The difference between you and many other people who receive health insurance through their jobs, is that you have broader rights as a public employee. You can fight the insurance company on several levels.

What to Do When Your Health Insurance Claim Is Denied

If the insurance company has wrongfully denied your health insurance claim, you must do the following before you are even in a position to fight back:

• Understand the reason why the insurance company has denied your claim
• Gather all documentation necessary to challenge the insurance company on the reason why they have refused to pay your claim
• Speak to a California health insurance claims denial attorney to both learn about your legal rights and put yourself in a legal position to contest the denial of your claim and potentially take direct action against the insurance company.

Before you can take your case to court, you may need to go through several steps first. The insurance company has an internal appeals process, and you may need to deal with them initially. Insurance companies are not known for reversing their own decisions, and they often only pay lip service to appeals. Then, you can also obtain an independent medical review through the California Department of Managed Health Care under certain circumstances.

You may be faced with the necessity of having to go to court to force the insurance company to pay your claim. While this is an unpleasant reality, the good news is that you get an independent review from a judge or jury who does not have their own interests in the outcome of your case, like the insurance company does.

You May Even Be Able to Seek Damages from the Insurance Company

As a sheriff or sheriff’s deputy, you have the same legal rights as anyone else when the insurance company has violated the law in denying your claim. You can file a lawsuit directly against the insurance company, both to force them to pay your claim and potentially even seek damages for their wrongful conduct. California’s bad faith law applies to claims filed by public employees. There are far less limitations on your right to sue because public employees are not subject to stricter rules imposed by ERISA.

What this means is that the insurance company may owe you money when you can prove that they broke the law. Some examples of bad faith that could subject the insurance company to liability include:

• Unreasonably deny your health insurance claim without a thorough investigation of its facts
• Misrepresenting the terms of your policy in coming up with the reason for denying the claim
• Subjecting a decision on your claim to an unreasonable delay
• Refusing to communicate with you about your claim

If the insurance company has broken bad faith law, not only would they need to cover your health insurance claim, but they would also need to pay you damages directly. You may even be able to obtain punitive damages from the insurance company if you take your case to court and win.

Contact a Health Insurance Claims Denial Law Firm

If your health insurance claim has been denied, you can fight back, the California health insurance claims attorneys at Quincey Law can take the insurance company to task on your behalf in a lawsuit. Schedule a free initial consultation by filling out an online contact form or by calling us today at (866) 945-9175.