The Affordable Care Act (“Obamacare”) has placed health insurers under substantial financial pressure. This pressure appears to be resulting in an increasing number of healthcare claim denials.
Unfortunately, the increase, if it exists, cannot be documented with hard data; historical data on the number of healthcare claim denials issued by private insurers doesn’t exist. The ACA now requires qualified health plans to report data on denials, but participating insurers only began doing so in 2015.
Anecdotal evidence, however, clearly points to an increase.
As a former Senior Counsel to the Maryland Insurance Administration, and now a private practice attorney concentrating in insurance law, I am receiving more and more calls from people facing financial crises caused by health insurers’ denials of large medical claims. I have represented a number of clients who had large health insurance claims denied, only to see the insurer reverse the denial once I was hired to fight back. Continue Reading