Mansell, Engel & Cole

Insurance disputes: Is consumer empowerment on the horizon?

If you’re old enough, you likely remember a time when you groused about forking over a $20 co-pay when you visited your doctor.

Millennials won’t understand that, but there was a time when Oklahomans and millions of other visitors to medical clinics paid s small up-front fee and often nothing else for medical care received.

And then we began that steady progression – unchecked over many years and still operative – marked by ever-spiking deductibles and other out-of-pocket costs. A service that might have cost a relatively paltry sum a generation ago can now easily run into the many thousands of dollars.

And, of course, there are now added complications owing to the sheer complexity surrounding coverage and treatment. Will the insurer step up to perform or refuse to pay for treatment it states was unnecessary? Will it delay or deny coverage on the alleged grounds that a patient and/or doctor did not secure company

preauthorization before undergoing a procedure or using a certain drug?

A recent article from the publication Modern Healthcare concedes the constantly growing challenge consumers often face when they square off against insurers for payments they believe they are entitled to as good-faith policyholders. That article simultaneously notes, though, that help doesn’t seem to be on the way anytime soon from any quarter. Its authors stress that there is scant bipartisan agreement in the U.S. Congress “to protect healthcare consumers from abusive practices by health plans.”

Perhaps a groundswell of strong public opinion demanding change will eventually produce some desperately needed changes in America’s health insurance industry.

In the meantime, aggrieved consumers can continue to look to a proven source of help when they need a strong advocate to contest an unjust insurance outcome. That is an experienced and aggressive pro-policyholder insurance law attorney.

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