Mansell, Engel & Cole

Oklahoma City Insurance Law Blog

What is the purpose of uninsured motorist coverage?

First of all, let’s clarify those acronyms. We are referring to UM and UIM, which are commonly used shorthand designations relevant to automobile insurance coverage. They come into play when a driver involved in an accident lacks sufficient coverage to fully compensate another motorist.

Here’s a representative scenario. You’re conscientiously negotiating the road when a negligent driver slams into your car (maybe he or she was speeding, tailgating, driving drunk or just flat-out distracted; the possibilities are many). Your injuries, while luckily not fatal, are serious. Moreover, they will unquestionably incur scores of thousands of dollars in medical expenses.

Opinion: Letting insurers act as doctors is truly dangerous

William E. Bennett Jr. has some strong views concerning insurers’ role in the treatment-approval process for patients, and he is not shy about communicating them.

Nor should he be. Bennett Jr. is a proven medical professional, being both a doctor and university professor of pediatrics. What he has to say about a deeply relevant insurer-linked issue in the health care community is notably important. We duly pass along the doctor’s key points to our readers across Oklahoma in today’s Mansell, Engel & Cole blog entry.

Just how key is securing health insurance for an Oklahoma worker?

Readers of our Oklahoma insurance law blog at Mansell, Engel & Cole might opt to just disregard the question posed above as our blog headline for today. A roll of the eyes might seem to be a more apt response.

Because the answer’s just that obvious, right?

Appeals are not the only option for denied insurance claims

Needing medical care can be complicated in many ways. You may worry about the procedure, medication and other aspects of treatment, and you may also have concerns about how you will pay for it all. Of course, because you have health insurance, you believe that your insurance provider will help cover at least a portion of the costs.

When you filed your claim with your insurance company, you may have anticipated having to wait a short time before you gained information on how much the insurance covered. However, what you may have not expected was for the company to deny your claim altogether. This information may have shocked you, and you may feel a bit panicked at the idea of having to pay for the entirety of your medical costs out of pocket.

Why do insurers so often deny a doctor-recommended treatment?

No reasonable person begrudges an insurance company’s efforts to maximize corporate profits, provided it does not compromise an insured’s health in the process.

After all, a coverage provider is no different than any other commercial entity in that it must do well to survive in the market place. An insurance company’s bottom line must stress profitability.

Variability of health care costs underscored in this story

Oklahoma residents doing their homework prior to making a major consumer decision duly focus on comparative shopping.

To wit: A careful would-be buyer doesn’t simply purchase a new car from a local dealer without first checking to see if there are nearby competitors selling the same model. Price is of course a motivating factor, and knowledge is power.

One key step unmentioned in this response-to-denial analysis

Aggrieved consumers in Oklahoma and nationally are hardly without resources when they turn for information concerning purposeful actions to take in the wake of insurance company denials. A simple online search query yields scores of websites addressing that issue in some fashion.

In fact, “how to respond to a bad-faith insurer’s denial” articles are virtually an industry unto themselves.

Revisiting “step therapy:” Oklahoma inks protective legislation

The concept is simple enough and eminently logical from an insurer’s perspective. It’s called “step therapy,” and it works as follows, illustrated through a representative scenario.

Say that you’re a patient with a serious condition that responds well to one particular medication. You are summarily informed by your insurance provider that your doctor-recommended drug is comparatively new and experimental and can be substituted for by an older and cheaper alternative.

Will a violent death mean denial of life insurance benefits?

Losing a loved one under any circumstances is hard enough, but when he or she died suddenly and violently at the hands of another person, your grief may be compounded.

No one expects his or her loved one to become the victim of murder, but it does happen. When you submitted your claim for the life insurance, the company may attempt to deny or at least delay your claim because of the circumstances surrounding the death of your loved one.

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