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

On Behalf of | Oct 1, 2019 | Denied Insurance Claims

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.

That is sad, isn’t it? The overwhelming amount of literature on that subject matter underscores the bottom-line truth that legions of policyholders in the United States are routinely stiffed by coverage providers that, well, don’t provide coverage.

Denial is of course arguably in good faith in some instances, of course. Maybe a drug or recommended treatment truly is still at the experimental stage, with more proven mainstays being readily available. Perhaps a diagnosis is wrong and needs revisiting.

Insured individuals and families across the country know well from hard experience, though, that a denial often denotes a simple duty-avoidance strategy far more than it does an insurer’s legitimate claim response.

What can an adversely affected insured party do?

Let’s morph back to the above-cited “how-to” primers. An entirely representative example recently published by one national news outlet counsels an insured’s systematic and patient approach. That strategy stresses a step-by-step graduated approach toward ticking off requirements and getting answers that unquestionably puts the heavy lifting on the policyholder.

To wit: Reread everything and contact the insurer in writing. Formally engage the review process. Solicit your MD’s opinion and support. Reach out to your company’s HR department (if applicable). Get a second opinion. Contact patient support groups.

Doesn’t that sound just a tad bit exhausting, especially if time lags on while maximum efforts along multiple fronts are completely unavailing?

The above-profiled strategy is certainly worth a read and merits consideration. We submit at the experienced pro-policyholders’ insurance law firm of Mansell, Engel & Cole, though, that it omits one key bullet point. Namely, that is an insured’s reasonable need in some cases to secure help from a proven and aggressive legal team.

A policyholder acting alone against an insurer acting in bad faith unquestionably faces an uphill challenge. The playing field can be greatly leveled via input from experienced insurance law attorneys.