UnitedHealthcare Insurance Claims Denial Lawyer
UnitedHealthcare has been the target of numerous lawsuits and enforcement actions for its failure to pay claims and its denial of health insurance coverage. If this has happened to you, you may want to hire a health insurance claims denial lawyer to help you fight back.
Attorney Nicholas Quincey at Quincey Law has fearlessly taken on large insurance companies throughout California, seeking justice on behalf of his clients and holding big business accountable. Quincey Law is the fighter that you need on your side when you feel like you are getting the short end of the stick from a large bureaucracy. We put power back into the hands of those who feel powerless.
Quincey Law has office locations in Orange County & San Bernardino County and handles UnitedHealthcare claim denials throughout the entire state of California. Contact Quincey Law at (866) 945-9175 or fill out a contact form to learn how we can vigorously protect your legal rights to have your UnitedHealthcare insurance claim covered.
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Perhaps the most common reason why UnitedHealthcare would deny your claim is that they feel that the treatment is not medically necessary. In other cases, the insurance company would argue the treatment is experimental, and that there is a more recognized medical treatment for your care. This reason is often given when health insurance companies deny claims for cancer treatment.
Other reasons for a claim denial include:
- The claim had incomplete information
- The medical care was subject to an exclusion in the policy
- The insurance company did not give prior authorization for the treatment
- The care was not covered under the terms of your policy
Examples of Health Insurance Company Misconduct
Some examples of insurance company misconduct when you have filed health care claims include:
- Wrongfully denying your benefits
- Taking too long to process your claim
- Delaying payment to the provider
- Misrepresenting the terms of your policy
- Denying claims without a clear explanation of why
- Failing to adequately investigate a claim before denying it
- Failing to communicate properly with you
Recently, insurance companies have been accused of over-relying on artificial intelligence to process claims and determine their payment. Some lawsuits have even alleged that insurance companies’ algorithms ignore or underweigh the recommendations of the treating physician in denying the claims.
Your Rights When UnitedHealthcare Has Denied Your Claim
Under California law, you have several legal options when UnitedHealthcare has denied your claim. First, you may want to file a lawsuit, seeking to force UnitedHealthcare to pay for the coverage you need. After all, a health insurance policy is a contract between you and the insurance company, and they are failing to uphold their own obligations when they refuse to pay a claim or otherwise act improperly.
Second, you may even have the right to sue UnitedHealthcare directly in a bad faith lawsuit. In addition to trying to compel UnitedHealthcare to pay your claim, you are seeking damages for their misconduct. The insurance company has a legal obligation to act in good faith towards you, both under the terms of their contract and under California law.
Insurance companies like UnitedHealthcare live in fear of bad faith lawsuits. Not only does a lawsuit have the potential to cost the company money, but it is also bad for business. Bad faith lawsuits could even prompt regulators to investigate and take action against the company.
Damages in a Bad Faith Lawsuit
Here, the insurance company would need to pay for the damages that their actions have caused you. Denial of a health insurance claim can cause you both economic and non-economic damages. You may suffer the following damages:
- Additional healthcare costs because you were denied the treatment that you needed
- Lost wages that you could have earned from your job had you recovered and been able to work
- Emotional distress damages for the worry and anxiety that you were forced to endure because of the insurance company’s wrongful practices
Punitive damages are what frightens companies like UnitedHealthcare the most. Juries have been known to order insurance companies to pay millions of dollars in bad faith cases to make an example and send a message.
Lawsuits Involving UnitedHealthcare Claims Practices
UnitedHealthcare has faced lawsuits, both for its denials of individual claims, and for its general practices in processing and responding to claims. Some recent lawsuits against UnitedHealthcare include:
- UnitedHealthcare was named in a class action lawsuit for its use of algorithmic practices in processing claims that have led to their denial. The lawsuit alleges that UnitedHealthcare continued to use this program, even though the company knew that it led to a high error rate.
- In 2019, the California Supreme Court upheld a $91 million fine levied against UnitedHealthcare because its internal practices led to the denial of scores of claims seeking coverage for vital treatment. Here, the court found that an insurance company does not need to have intent to break the law to be punished for its practices.
- In a long-running legal battle that has reached the California Supreme Court, UnitedHealthcare has been accused of bad faith for their role in what is alleged to be the premature discharge of a patient from a rehab facility who eventually died.
Contact a California Health Insurance Claim Denial Attorney Today
Quincey Law handles claims against large insurance companies, such as UnitedHealthcare throughout the state of California. Call (866) 945-9175 or fill out our confidential contact form to speak to someone at our office. Together, we can seek justice.