When you are paying your insurance premiums every month, the last thing you expect is to have your claim denied when you need the benefits most. But unfortunately, that is a reality many people face. Whether it is dealing with a health insurance denial or fighting for the life insurance benefits you are owed after losing a loved one, the experience can be frustrating.
You might feel like you are up against a giant, with all the odds stacked against you. And let us be honest—most of us are not prepared for the complicated world of insurance law. That is where we come in. At Kantor & Kantor, we understand what you are going through because we have helped countless others in similar situations. We are here to listen, guide you, and fight for your rights.
Our mission is simple: to ensure you are treated fairly and that the insurance company holds up its end of the bargain. You are not just another case file to us—you are a person who deserves the support and benefits you have been promised.
Contact our San Francisco insurance law attorneys at 818-886-2525 for a free consultation.
Why Are Insurance Claims Denied?
Dealing with insurance claims can feel like a tug of war. Often, you do everything right, yet your claim still gets denied. Here is why this might happen:
- Missing Information: One of the most common reasons for denial is missing information. Insurance companies require specific documents and details to process a claim. If you leave something out, even by mistake, your claim might get denied.
- Pre-existing Conditions: Insurance companies often deny claims based on pre-existing conditions. They might argue that your illness or injury existed before your coverage started. This is a frequent issue with health and disability insurance claims.
- Policy Exclusions: Every insurance policy has exclusions – specific conditions or situations that are not covered. For example, some health insurance policies do not cover certain treatments. If your claim falls into one of these exclusions, it can be denied.
- Administrative Errors: Sometimes, claims get denied due to simple administrative errors. A typo, incorrect date, or misfiled document can lead to a denial.
- Failure to Meet Deadlines: Insurance companies have strict deadlines for filing claims and appeals. If you miss a deadline, even by a day, your claim can be denied.
- Fraud or Misrepresentation: If the insurance company believes you have provided false information or misrepresented facts, they can deny your claim. This is why it is essential to be honest and accurate in all your communications.
Steps to Take if Your Insurance Claim Is Denied
Receiving a denial on an insurance claim can be disheartening, especially when you are counting on those benefits. However, a denial is not the end of the road—there are several steps you can take to challenge the decision.
First and foremost, do not panic. Take a deep breath and carefully review the denial letter. Insurance companies are required to provide a reason for denying your claim, and understanding their rationale is crucial. Look for any specific points or terms mentioned, as this will be your starting point for building your case.
Once you understand why your claim was denied, gather all relevant documentation. This includes your insurance policy, correspondence with the insurance company, medical records, bills, and any other evidence that supports your claim. Having a complete and organized file will make it easier to present your case clearly and effectively.
Next, contact your insurance company and request a copy of your “claim file.” A “claim file” is a collection of documents and records that an insurance company maintains related to an insurance claim. When a claim for benefits is filed, the insurance company compiles all the information it uses to make decisions about the claim, including medical records, correspondence, internal notes, policy details, and other evidence it considers in approving or denying the claim. If your claim is governed by federal law, you are automatically entitled to a copy of the claim file.
If your initial efforts to resolve the issue with the insurance company are unsuccessful, the next step may be to file an appeal. Most insurance policies have an appeals process, and it is important to follow it meticulously. Submit a formal appeal letter, clearly outlining why you believe the denial was incorrect, and include all the supporting documentation you have gathered. Only talk to insurance companies in writing. Be sure to meet any deadlines specified in your policy to avoid losing your right to appeal.
Throughout this process, keep detailed records of all your interactions with the insurance company. Note the dates, times, and names of the representatives you speak with, as well as summaries of your conversations. This information can be invaluable if you need to escalate your claim further.
Our experienced insurance lawyers can provide invaluable assistance, helping you understand your rights, building a strong case, and advocating on your behalf.
Why Choose Kantor & Kantor?
When you are up against an insurance company, it can feel like you are fighting a giant with endless resources. At Kantor & Kantor, we know this fight all too well, and we are here to stand by your side every step of the way.
What sets us apart is our commitment to our clients. We are not just lawyers—we are people helping people and care about what you are going through. We understand that behind every claim are real people with real worries, frustrations, and hopes. That is why we take the time to listen to your story, understand your needs, and craft a tailored strategy.
We have built our reputation on being relentless advocates. Insurance companies know that when they face Kantor & Kantor, they are dealing with a firm that does not back down. We fight hard because we know what is at stake for you—your health, financial stability, and peace of mind.
But it is not just about winning cases. It is about how we make you feel during the process. We strive to be approachable, compassionate, and always available when you need us. We believe in clear, open communication, so you are never left in the dark about what is happening with your case.
How Our San Francisco Insurance Law Attorneys Can Help
Our San Francisco insurance law attorneys will stand by your side every step of the way, ensuring you are never just another case file on a busy desk.
Case Evaluation
We start by listening—really listening—to your story. We know that every detail of your experience can shed light on the path to a solution. By understanding the specifics of your situation, we tailor our strategy to suit your unique needs. Our attorneys will keep you informed and involved at every step.
Expert Policy Analysis
Insurance policies are notoriously complex and deciphering them can be difficult. Our attorneys excel in translating insurance language into clear, actionable plans. We will explain your policy’s coverage in straightforward terms and identify the key issues that are affecting your claim.
Aggressive Advocacy
When it is time to face the insurance companies, we are tenacious. We will not be pushed around by big insurance firms, and we will stand up for your rights with unwavering determination. Our goal is to ensure that the insurance companies fulfil their obligations to you, and we are prepared to fight tirelessly to see that they do.
Results-Focused Strategy
At the end of the day, results matter. We are focused on achieving the best possible outcome for you, whether that is through negotiation, settlement, or winning at trial. Our track record speaks for itself, and we pride ourselves on making a real difference in the lives of our clients.
Contact Our San Francisco Insurance Law Attorneys Today
When you are dealing with an insurance dispute, it can feel like the odds are stacked against you. It is easy to feel frustrated when the company you trusted to protect you is now putting up roadblocks.
At Kantor & Kantor, we know the stress and uncertainty you are feeling. We are people helping people, and we are here to shoulder that burden with you. Our goal is simple: to fight for the benefits you deserve so you can focus on what truly matters—moving forward with your life.
We understand that reaching out to a lawyer might feel like a big step, but it is a step toward taking back control. We are not just here to provide legal advice; we are here to listen, to understand your unique situation, and to advocate for you. So, if you are facing an insurance challenge, know you do not have to navigate it alone.
Contact our insurance law attorneys in San Francisco at 818-886-2525 for a free consultation. Let us help you turn the page and start writing a new chapter where your rights are respected, and your voice is heard.
Attorney Glenn R. Kantor
Glenn Kantor is a founding partner of Kantor & Kantor LLP. As a young attorney, Glenn saw the injustice of wrongful insurance denials and created a law firm to represent individuals seeking to obtain their rightful benefits. Glenn is committed to ensure that clients receive the benefits they are entitled to under their insurance policies or group health plans. [Attorney Bio]
