Health Insurance

Wilsonville Health Insurance Lawyers

CALL US AFTER A DENIED HEALTH INSURANCE CLAIM

Health insurance companies like to present themselves as friendly neighbors who only care about doing the right thing for their policyholders. If you have ever filed a health insurance claim, though, then you know that the truth can be quite the opposite. Denied health insurance claims are becoming increasingly common, and many of those denials do not adhere to the terms and conditions described in the policies that they sell.

At Kantor & Kantor, LLP in Wilsonville, you can find all the legal help you need to deal with a stubborn health insurance company that denied your claim. We can review the denial letter to see if your insurer has any valid grounds to deny you the benefits. If they do not, then we can work with you to prepare a challenge or appeal.

We have experience taking on all sorts of health insurance companies, including:

  • Aetna
  • Anthem Blue Cross
  • Blue Shield
  • Health Net
  • Kaiser
  • Met Life

Major insurance companies scare away the average law firm with little experience with insurance claims. We have been focused on insurance claim denials for more than 20 years, though, so there is nothing the opposition can do to intimidate us.

Get a trusted team of lawyers in your corner. Call (877) 783-8686 now.

MATERIAL MISREPRESENTATION IN HEALTH INSURANCE CLAIMS

Health insurance companies do have many valid reasons to deny a claim. The problem is when they choose a reason that does not apply to the situation, or when they do not give you a reason at all. One of the more commonly exploited “reasons” to deny a claim is called material misrepresentation.

When you fill out an insurance application or renewal form and include incorrect or inaccurate information, it is known as material misrepresentation. Technically, any misinformation provided is a material misrepresentation. Although, a health insurance claim should not be denied for a material misrepresentation unless that misinformation is significant enough to alter the validity or the outcome of a claim.

Four examples of common material misrepresentation not mentioning:

  • Cigarette, vape, or tobacco use
  • Illegal narcotic use or addiction
  • Preexisting medical conditions like heart disease
  • Naturally dangerous hobbies like skydiving

The prior examples would probably give an insurance company a valid reason to deny a claim. Something like listing the wrong eye color does not. If your health insurance claim was denied due to material misrepresentation, then let our insurers dig into the details and find out why. If we can uncover that the alleged material misrepresentation was something completely harmless, then we will be ready to challenge the denial outright.

DO NOT LET A CLAIM DENIAL GO UNANSWERED

You can never be sure when an insurance company will intentionally deny your claim without a valid reason. If your health insurance claim is denied, then you should always speak to an attorney and explore your legal options. Otherwise, you will be placing all of your healthcare bills directly on your own shoulders when there should be an insurance company backing you up.

You might have already filed an appeal that was rejected by your insurance company. In this situation, you are still not out of options. Our Wilsonville health insurance claim attorneys would be happy to look into the denial for you and see what you should do next.

What might we need to do to seek health insurance benefits for you?

  • Challenge a health insurance provider after you received out-of-network medical care
  • Review your policy for one-sided clauses that put you at an unfair disadvantage
  • Dispute material misrepresentation denials based on insignificant mistakes

We want you to be able to rest comfortably after receiving necessary medical care without needing to worry about if your bills are covered. Let us stand up for you after a claim denial, so we can turn that ideal situation into a reality.

For a free consultation, call (877) 783-8686 at your next opportunity.

Client Testimonials

  • “Your kindness will never be forgotten.”

    - Lori & David
  • “First of all, I want to express my extreme gratitude for probably saving my daughter's life.”

    - Anonymous
  • “I won the appeal.”

    - Terry S.

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