Mansell, Engel & Cole

Prove your condition is 'medically necessary' to insurers

If most of us could, we would avoid seeing the doctor and having any medical procedures or treatments done. An ideal world would mean we and our children are healthy all of the time. In an ideal world, health insurance wouldn't be so confusing or as expensive.

We live in the real world, however, and in this reality you will have doctor appointments. You, your spouse or your children will suffer medical conditions and require treatments or medicines that cost money.

You have medical insurance? Great. That can make things easier -- until a health insurance claim gets denied

Most of us tend to trust what our medical providers tell us. If a doctor tells us that a treatment or procedure is necessary, we fall in line. We schedule that appointment. We take that medicine. We take that doctor's advice for the sake of our health or the health of our loved ones.

If a medical matter is described by your doctor as necessary, you would think that the health insurance you've paid for covers at least part of the cost. Too many people are faced with the scary surprise through their medical bills that, whoops, their insurance isn't going to cover what they thought. 

Don't take that bill and high cost of treatment as a final verdict. Health insurance providers make mistakes, or try to get away with bad faith treatment toward their consumers. Fighting a denied health insurance claim is a legal option and can lead to clarification of the dispute, as well as overall justice for you and your family.

You have paid for your medical insurance. Doing so probably hasn't always been easy, but you have paid for it and deserve coverage when a medical issue is medically necessary. An insurance law attorney can talk you through some of the common excuses companies will give for not covering your costs and help you refute those arguments. 

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