Recent Blog Posts
A sprawling federal investigation recently uncovered over 200 life insurance claims that were denied by Prudential Financial due to a lack of “evidence of insurability” between 2017 and 2020. “Evidence of insurability” is a term of art in the insurance industry and is a standard requirement of the underwriting process in many areas of insurance.
Transparency is a modern buzzword gaining traction in many areas of public life. It’s been a part of the healthcare arena since at least 2010 and seems to have kicked into high gear starting in 2020. Yet even today, consumers struggle to find out what health services will cost upfront, and healthcare providers and insurers continue to strive to keep that information secret and hidden from patients until the bill comes after the fact.
Life insurance is a crucial financial safety net for many families. However, situations may occur where life insurance claims are denied, causing distress and financial strain to beneficiaries during an already trying time.
If your health insurance claim is denied, delayed, or underpaid, you could end up paying out of pocket for costs that should be covered, forcing you to get a lawyer and fight the system to get reimbursed after the fact. In the worst case, you could wind up forgoing medical care altogether because you can’t afford the treatment. Wrongful health insurance denials are insidious; not only do you not get the coverage and benefits you’ve paid for, but a claim denial can be damaging to your health. People have died while waiting for their insurance companies to come through for them.
Insurance is a complex field, and we reasonably rely on insurance brokers and other professionals to help us navigate different policy options. The insurance market is risky for individuals and businesses; parties seeking insurance are increasingly relying upon insurance brokers and agents to secure the policies they need. Brokers and agents are people, however, with competing interests and differing levels of competence. If you rely on an insurance broker to get you a specific policy and they fail to do so, only for you to find out years later when you (or your beneficiaries) need that coverage you thought you bought, you might find yourself in dire financial straits.
Medicare Advantage policyholders have their claims denied at an outrageous rate, according to the federal government’s own reporting. On the bright side (sort of), claimants who appeal their denials are by and large successful in eventually getting their claims approved. If you’ve had your legitimate Medicare Advantage insurance claim denied, there are steps you can take to get the coverage you need and are entitled to, and you might also have a right to monetary damages based on your insurer’s violation of the law.
If your insurance claim was denied, and you believe that you should have been covered, it does not necessarily mean that either you or the insurance company were wrong. While insurance companies certainly do deny claims in bad faith, sometimes a lapse in coverage is due to a miscommunication between the insured party and the insurance agent.
Servicemembers Group Life Insurance: What It Is, Who Is Eligible, and Why Claims Most Often Get Denied
The people who put their lives on the line to defend our nation and our freedoms deserve to be venerated for their dedication and sacrifices. Active-duty servicemembers and veterans are awarded a variety of benefits for their service, and with good cause. Unfortunately, utilization of these benefits does not always play out smoothly. Families of covered servicemembers are entitled to life insurance benefits when the insured party passes away, but in many cases claims are delayed for weeks or months if not flat-out denied.
We’ve previously discussed some of the many reasons insurance companies give for turning down claims. Insurance companies are often wrong when they make these determinations, but how do you go about convincing them of their mistake? You have a right under state and federal law to appeal a health insurance claim denial, but you must follow certain steps in a certain order under defined time frames. We talk about those steps below.
Life insurance policies are only valuable so long as the insured continues to keep up with premium payments, which might be set up to be paid monthly, semi-annually or annually. If those payments stop, the policy is said to lapse. Once the policy lapses, it is no longer in force, and no benefits will be paid when the (formerly) insured passes on. A lapsed whole-life policy might have built up some cash value and be worth something as part of the deceased’s estate, but a lapsed term life policy is not worth anything at all.