Mansell, Engel & Cole

Oklahoma City Insurance Law Blog

Insurance denial advice: Be attentive and persistent

Examples of insurance companies’ so-called “bad faith” regarding their lack of performance in contracts with policyholders aren’t exactly in short supply.

We note a few representative examples from a wide universe of possibilities on our pro-plaintiffs’ website at the long-established Oklahoma law firm of Mansell, Engel & Cole. Those include things like the following:

What to do if your insurer strings you along

Another Oklahoma winter is coming to an end, but not without a fight. In addition to cold and snow, your region may be among those that experienced hail and high winds with the last storm system. The force of Mother Nature spared your loved one's any injury but left your home damaged.

Perhaps you need the roof replaced, or windows blew out from wind or tree branches. You may be eager to begin repairs, especially if the damage has made your property, or at least a room or two, uninhabitable. You did your due diligence in filing a claim to your insurance company, but you still haven't received the money from your policy. You have every right to feel frustrated and to wonder if there is something you can do about it.

MD's sharp critique: Here is what's really going on re care denials

Do you want to peruse a soft and conciliatory communication from a seasoned physician weighing in on the causes and effects of denied health care for patients?

If so, don't read an opinion piece recently crafted by a doctor writing in an online publication advocating for the smooth and logical delivery of medical care to the general public.

An obvious source of frustration for patients and their doctors

A chief policy maker at national health insurer Blue Cross says that it is precisely because her company "really, truly" cares about what is best for its policyholders' health that it often denies MD-suggested care treatments and tests.

A patient featured in a national report on insurance denials counters that such a claim is sometimes bogus and smacks more of mere paternalism.

Will Anthem deny insurance claims for emergency visits?

Patients with insurance have an expectation that if there is an emergency, they will receive coverage for an emergency room visit. However, a new policy by one of the nation’s largest insurance companies may not cover these visits.

Last year, Anthem began reviewing emergency room visits after the fact to decide if those visits were “medically necessary.” If the insurer determined the patient didn’t suffer from what the company deemed an “emergency medical condition,” they would refuse to pay for the visits. This led to patients who were expecting coverage to be left with thousands in medical bills.

Why having LTD insurance can be vital for individuals, families

How important is it for most individuals and families in Oklahoma and nationally to have a reliable and protective long-term disability insurance policy in place to cover protracted health challenges that can arise in life?

Commentators on that subject matter mince no words when they venture their opinion. They cite to broadly sourced reports and statistics that evidence this: Having a quality policy in effect can spell the difference between continued financial solvency and sheer economic woe.

Prepare for tornado season with these 3 tips

Every year tornado season seems to come up faster than the year before. The months where tornadoes are most active are March-June, so whether we are ready for it again or not, tornado season is here once again.

To ensure your family is prepared for the season, follow these three tips:

How do you know your insurance company acted in bad faith?

When you purchased an insurance policy for your car, your home or your life, among others, you agreed to make periodic payments in exchange for the peace of mind that if you file a claim after an accident, injury or damage to your property, the insurance company would be there to provide you with financial assistance you need.

You diligently made those payments, probably for years, but when you filed a claim, the insurance company failed to come through for you. The company you relied on denied your claim. The question then becomes whether the insurance company acted in "bad faith."

National insurer once again in news for wrong reasons

Message to Aetna principals: You seriously might want to give some thought about injecting greater rationality and fairness into your insurance claim review process.

We last spotlighted Aetna -- one of the nation's largest insurance providers -- in our February 12 blog entry. We noted therein the stunning news that the company's former medical head routinely denied policyholders' claims over many years without ever once consulting with doctors. He admittedly relied solely on nurses' input and, moreover, rarely spoke with them.

Spotlight on what many view as Anthem's chilling, bad-faith policies

It's midnight and your young child is screaming in pain. You have sought desperately to understand what is going on and have taken every measure you can think of to alleviate the symptoms. After being wholly unsuccessful in efforts to help your loved one, you rush to the local emergency room for help.

That judgment just might save your child's life. Additionally, it could rip holes in your budget and perhaps even bankrupt you -- in the event your health insurance card identifies you as an Anthem policyholder.

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