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Orange County Health Insurance Claim Denial Attorney – Serving California

Attorney Nick QuinceyHealth insurance companies are subject to strict regulation under California and federal law. When your case is governed by state law, you may be able to sue the insurance company directly for misconduct. You may also sue insurance companies for violations of specific laws, such as the Mental Health Parity and Addiction Equity Act.

Quincey Law can take on large insurance companies when they are skirting the law and giving you the runaround.

California has consumer-friendly healthcare laws that are intended to protect you. The health insurance company cannot delay your claim, and there is oversight if they wrongfully deny your claim. They may be forced to pay a claim that they have wrongfully denied, and they can even be sued if they have broken the law.

Call attorney Nicholas Quincey at Quincey Law today when the health insurance company has wrongfully denied your claim or they have told you that they will refuse to pay for your benefits. We will take the time to listen to you, and we will advise you whether you have any potential legal recourse against the insurance company. You can schedule a free initial consultation to discuss your claim by calling (949) 844-6630 or you can submit a contact form to schedule a free consultation.

Quincey Law helps clients with health insurance claims denials throughout California and is located at 34135 PCH, Ste 318 Dana Point, CA 92629 just a few blocks west of the intersection of Golden Lantern & PCH. Call attorney Nicholas Quincey today at (949) 844-6630 regarding your denied health insurance claim or reach out by submitting a contact form to schedule a free consultation.

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Nick fights hard for his clients. Guided by a strong moral compass, he provides fair and honest insight as to what is in your best interest. He is incredibly diligent, and a straight shooter. You feel like he is always in the trenches with you, and guiding you through tough times. I am so grateful to have worked with him on matters over the last few years. I cannot recommend him highly enough.
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Timeliness Requirements for California Health Care Claims

California law recognizes that your health cannot wait for your claim to be addressed and approved. There are strict requirements imposed on insurance companies for processing and responding to your claim. They must recognize a claim within 15 days, and they must approve or deny it within 40 days after receiving it.

Health insurance companies will rarely blatantly violate the law. They will use various procedural tricks to make it look like they are acting timely, when they are really just delaying your claim. If they have failed to follow the law, they could be legally liable.

TIME IS OF THE ESSENCE – Call us now at (949) 844-6630 

Health Insurance Claim Denial

There is oversight that keeps the insurance company from having the final word when they deny a health insurance claim. First, you would need to go through the insurance company’s internal appeal process. That may be little comfort to you when you are awaiting critical care, but it is a step that you must take. After the insurance company continues to deny your claim, there are additional steps that you can take.

You can involve the Department of Insurance and have them review the denial of your claim if you purchased the health insurance policy on your own (there are different procedures that involve the federal government when your insurance was provided to you as an employee benefit). Depending on what they find, they may even order the insurance company to cover your claim.

You can request an independent medical review if the insurance company denied your claim because they said it was not medically necessary. You can also obtain review if the insurance company has denied emergency medical services or those that they argue are experimental in nature. If the insurance coverage says that a service is not a covered benefit, you can also have independent medical review to determine whether the decision was correct.

Handling Health Insurance Denials Involving:

Mental Health Parity Claims

Federal law made major changes to how insurance companies cover mental health care treatment. Health insurance companies cannot impose separate fee schedules and treatment limitations on mental health care if it is covered by the policy. Mental health parity means that these types of claims must be treated as any other medical claims would under the policy. For example, if the plan provides for out-of-network benefits for physical health care, it must do the same for mental health care. Health insurance companies have often faced class action lawsuits from their denial of mental health claims.

Bad Faith Lawsuits Against Health Insurance Companies

If your health insurance company has pushed the boundaries too far, they may even be sued in a bad faith insurance lawsuit. There are certain limits on what they are allowed to do. If they have done something like misrepresenting the language of your policy to deny a claim or unreasonably delay responding to your claim, they can be liable to you for the damages that they have caused through their wrongful action. The failure to act reasonably promptly in response to member communications can even be an example of bad faith that allows you to file a lawsuit.

Contact Quincey Law Regarding a Health Insurance Claim Denial

Call Quincey Law today when you need to take on your health insurance company and hold them accountable. Our health insurance denial attorneys serve Orange County including Anaheim, Santa Ana, Irvine, Huntington Beach, Garden Grove, Fullerton, Orange, Costa Mesa, Mission Viejo, Westminster and all throughout California. We can listen to the facts of your case during a free initial consultation and let you know whether there is the potential for a lawsuit. Call us today at (949) 844-6630 or fill out a contact form to schedule an appointment to speak to a lawyer.