Los Angeles Health Insurance Bad Faith Attorneys
When you submit a claim to your health insurance provider following an injury or illness, the company will sometimes not fully cover, or even deny, the claim. There are a number of reasons why they may do this, some which may be the result of the health insurance provider acting in what is known as bad faith.
At the core, health insurance companies act in bad faith when they deny a valid claim covered under your policy.
Why would a health insurance company do this to their client?
It’s important to remember that these companies’ primary goal is to make money. Health care is a multi-billion dollar industry that continues to grow.
A common excuse from health insurance companies’ is “lack of medical necessity”, even if your doctor is saying otherwise.
A health insurance company may act in bad faith in a number of other unfair practices, including, but not limited to:
- Denying claims specifically covered under a policy
- Failure to provide any reasoning for the denial of a claim
- Complete failure to either explain the reason for denial, or even acknowledge the claim
- Stalling tactics, such as requiring you to submit to additional medical tests
- Misrepresentation of benefits associated with the policy
- Not authorizing any necessary medical treatment you are entitled to under your policy
- Not paying you the full value of your claim
Just because your claim is denied does not mean your health insurance company is acting in bad faith. If the claim does not meet the parameters in your policy, the company has the right to deny the claim.
Further complications for potential bad faith claims involve the distinctions between ERISA policies and non-ERISA policies
Many insurances are issued pursuant to the Employee Retirement Income Security Act of 1974 (ERISA) – a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans.
You cannot file an insurance bad faith lawsuit for an ERISA policy. Claims pertaining to ERISA policies are limited to the contract benefits wrongfully denied and the attorney fees you incurred to obtain the wrongfully denied benefits.
However, if you have a non-ERISA insurance policy, you may sue for insurance bad faith.
Some examples of non-ERISA insurance policies are those purchased on an individual basis through Covered California and group policies issued to public employees.
If you file an insurance bad faith lawsuit, you are not limited to recover only the insurance benefits wrongfully denied. You may also seek recovery for emotional distress and punitive damages.
The statute of limitations for an insurance bad faith cause of action is 2 years from the date your insurance benefits were wrongfully denied. If the two years has already passed, you may still sue on a breach of contract cause of action, but the damages you may recover are more limited.
The statute of limitations for a breach of contract cause of action is 4 years from the date your insurance benefits were wrongfully denied.
There are a number of injuries for which someone may see their claim denied. They might include:
- Long term effects from a traumatic brain injury
- Slip and fall
- Broken bones
- Head and neck injuries
- Construction accidents
An insurance company might even deny claims for serious illness or treatments for specific health conditions, including:
- Autoimmune disorders like lupus or multiple sclerosis
- Heart disease
- Mental health conditions
At C&B Law Group, our team is prepared to assist you following an with your insurance bad faith claim. Our lawyers work on a contingency fee basis, meaning you don’t pay us unless we win.
Furthermore, we have an incredible track record of settling successfully resolving 99% of our injury cases. This includes over 3,000 cases in six years.
We will work within our legal power to help you recover your damages, including:
- Your insurance benefits to cover your medical expenses
- Loss of income/wages
- Emotional distress
- Punitive damages
- Medical expenses
Your initial phone consultation with our attorneys is free. We’ll review your case, and ensure we have the necessary information in order to take the next steps.
Remember that each case will have its own set of unique circumstances.
Our Los Angeles insurance bad faith lawyers are here to fight for you. Contact us today at (855) 477-2365