While our politicians debate the merits of the Affordable Care Act (a.k.a. “Obamacare”), insurers continue to deny health insurance claims by the thousands every year. These denials often saddle consumers with outsized medical debts they cannot afford.
As a former Senior Counsel to the Maryland Insurance Administration and now an attorney in private practice, I have been receiving an increasing number of calls from individuals facing personal financial crises caused by health insurance claim denials. Unfortunately, there is a real difference between obtaining a health insurance policy and forcing the insurer to provide coverage when you need it most.
Large claim denials can devastate a family’s finances and add to the stress caused by serious illness or injury. Some of my clients have been stuck with six-figure medical bills and forced to fight their insurance company even while struggling to regain their health. Fortunately, when insurance claims are improperly denied, policy holders do have options. They can often force their insurers to reverse their initial denials and provide coverage.
A case in point: I recently convinced BlueCross BlueShield of Maryland to withdraw voluntarily a denial of coverage for a $160,000 microprocessor-controlled “Genium” prosthetic knee. Continue Reading