
Don't simply take your insurance company's word on a claim denial. A Florida insurance lawyer can help you enforce a valid claim.
Statistics show that some 30 percent of medical insurance claims get rejected and, of them, fewer than half are resubmitted. While some denials are legitimate, as many as 10 percent of claims submitted are unjustly denied. If your insurance company denied your claim or paid you less money than you believe you’re entitled to, don’t simply take their word, Florida insurance lawyers say. Steinberg & Linn, PA offers these tips for getting the financial compensation your insurance policy promises.
- Insist upon a written explanation of the insurance company’s denial. Florida state law requires companies to provide written explanations, so if yours fails to comply, they could face legal trouble.
- Do your research. Once you’ve received a letter explaining the reasons for your claim’s denial, start your own investigation by carefully reading your policy. Insurance companies and insured patients may interpret a clause differently – and companies have been known to exercise “selective interpretation” to justify a claim denial. If you received a payout that was less than you expected, check to see what other doctors in the area charge for the same treatment. If there’s a significant difference, you may have a case for additional dollars.
- Check for violations on the insurance provider’s part. If the insurance company says you’re to blame for incorrectly completing a claim for or missing a deadline, their excuse may not cut it legally. The insurance company must show that your error harmed the company or impeded their ability to adequately investigate to get out of paying an otherwise valid claim. Also, many insurance companies will point to a system-wide reduction of coverage. But if they failed to notify you about a reduction, that’s a violation of insurance law.
- Ask for help. Talk with your doctor, insurance agent, group policy manager at your workplace, a representative with Florida’s Department of Insurance, a professional arbitrator or an experienced Florida insurance attorney. Each of these people can help bolster, mediate or litigate a valid insurance claim.
- Keep copious records. In all communications with your insurance company over your denied claim, keep records of the date and time you called, the name and position of the person to whom you spoke and notes summarizing each conversation. Keep copies of all relevant bills and documents. Send letters by registered mail, so that you have proof of the company’s receiving them. If the situation turns into a legal one, you’ll need to show that you gave the insurance company ample opportunity to justly address your claim.
Steinberg and Linn’s Florida insurance attorneys have years of experience and a strong track record in securing sizeable insurance recovery claims for clients. Contact our Port Charlotte, Fort Myers or Naples offices for a free consultation.










