Freundlich & Littman, LLC

Health Insurance Claim Lawyers

You pay premiums every month for coverage you expect when you need it most. When your insurer denies, delays, or lowballs the claim, you have options.

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Insurance Litigation

Most people do not think about their health insurance policy until the moment they need it. That is exactly when the details start to matter: what the policy actually covers, what documentation the insurer can demand, and how long it has to respond. Health coverage may be private or public, and the process for Medicare and Medicaid claims differs from private insurance in ways that affect appeal rights and processing times. If your insurer stops behaving like it intends to pay, that is the point to bring in counsel rather than the point to wait.

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Lead attorney on every case we take, backed by a dedicated legal team you work with directly.

Coverage should be close to automatic. You hand your card to the doctor or pharmacist and the claim processes on the spot. When it does not, contact the insurer to find the problem, then get legal advice, particularly if you are in poor health and not in a position to fight a claims department yourself. Keep every piece of paperwork connected to the claim until the process finishes or your attorney tells you otherwise. Expect follow-up requests, including for another examination or for proof of medical necessity.

After an investigation the insurer may offer to settle. With medical bills piling up, a low offer is tempting, and you are entitled to decline it and to get advice about other avenues first. If the claim is denied outright and a phone call does not resolve it, have your attorney contact the insurer directly. Insurers treat a policyholder differently once counsel is involved, and that difference is often what separates payment from medical debt. Every case here is assigned a lead attorney and a dedicated legal team, and the consultation is free, confidential, and carries no obligation.

Health Insurance Claims

Health insurance law has taken interesting turns in the past few years. As it stands, every American must have insurance. Unless an individual files an exemption, the government will levy a penalty tax for not having insurance. Whether you have private or public health insurance, the policy remains the same.

In fact, people tend to not think about health insurance until they need it most. Health insurance policies are important for Philadelphians to read. Once you obtain health insurance, make sure you understand everything in your policy. If at any time your health insurance company does not appear to have high standards, you should contact a health insurance claims lawyer immediately.

Freundlich & Littman, LLC are your greater Philadelphia health insurance claims lawyers. If you are in need of a lawyer to fight your health insurance provider, we are here for you.

Frequently Asked

Health Insurance Claim Lawyers: Frequently Asked Questions

What should I do first when a health insurance claim does not go through?

Contact your insurance company to check for problems, then seek legal advice. Keep every document connected to the claim safe until the process finishes or your attorney directs otherwise. An attorney can speak on your behalf, which matters most when you are dealing with poor health at the same time.

My claim was denied. What can I do?

If a call to the insurer does not fix it, contact your attorney and have them reach the insurer directly. Insurers tend to disregard a policyholder who appears to lack leverage. A denial is not the end of the process, and you can appeal, but the decision about how to appeal is worth making with advice.

Do I have to accept a settlement offer from my insurer?

No. After investigating, an insurer may offer to settle for less than the claim is worth, and mounting medical bills make a low offer tempting. You have the right to deny the offer and the right to seek legal advice about other avenues before you decide.

What is an examination under oath?

It is a formal proceeding insurers use to screen for fraud and for claims they believe they do not have to cover. Answers are given under penalty of perjury. Because the transcript follows the claim from that point forward, it is strongly advised to have legal representation lined up before the examination.

Can my insurer reevaluate my policy after I file a claim?

Some do. If you have a preexisting condition or an ongoing illness, an insurer may route your file back through medical underwriters after you make a claim. Underwriters valued your policy when you signed up, and changing the terms of the policy after the claim is grounds for a lawsuit.

Is the process different for Medicare or Medicaid?

Yes. Public coverage follows different rules than private insurance, including different appeal rights and processing times. The general path is the same, though: get legal advice early, follow the guidance you are given, and keep every document connected to the claim.

What does it cost to have you review my claim?

The initial consultation is free. We look at your policy, the denial or offer you received, and the documentation you have, and explain what we see and what your realistic options are before you decide whether to move forward.

How Do I File An Insurance Claim?

Health insurance coverage should be automatic. You should take your insurance card to the doctor or pharmacist so that they may process your insurance on the spot. If the insurance does not go through, your next step is to get in touch with your insurance company to check for problems. You pay money each month and deserve the have the fullest protection for your money. Your next priority is to seek immediate legal advice. A health insurance attorney can speak on your behalf, especially if you are in poor health. Health insurance may be private or public, depending on your situation. The process for Medicare and Medicaid claims are different than private insurance. It is important to understand that aspects like appeal rights and process times are, therefore, different. No matter the type of health insurance that covers you or your family, your actions should follow the same path. First, contact legal representation and follow their specific guidelines. As a general rule, always keep any paperwork related to your medical insurance claim safe until the claim process finishes or directed otherwise by your health insurance claim lawyer. After filing a claim with your medical insurance provider, you may receive communication for more information about your medical issue. Prepare yourself for several questions, including requests to see another doctor. Your insurance company may also request proof of medical necessity for your medical claim or a claim to use a brand medication over the generic. After their investigations into your claim, you may receive an offer to settle. With mounting medical bills, their low offer is tempting. You should know that you have the right to deny the offer. Further, you reserve the right to seek legal advice to discuss other avenues to take. An experienced health insurance claims lawyer can help you to navigate the process from start to finish.

Denied Benefits?

If your insurance company denies your claim, you have options. If a simple phone call to your insurance company does not work, contact your attorney straight away. In fact, you should have your attorney contact your health insurance provider on your behalf. Insurance companies disregard the average policyholder when it seems they lack power. This is where a health insurance claims attorney can make the difference between compensation and medical debt. When deciding whether to appeal your health insurance denial, do not hesitate to seek outside advice. Contact Freundlich & Littman today to schedule a free consultation.

What Happens With the Claim?

First, your insurance company may call you for an examination under oath. Insurance companies use these legal proceedings to weed out fraud and claims they do not have to legally cover. With this summons, you should know any answers are under the penalty of perjury. To avoid finding yourself in a complicated legal process, it is strongly advised to seek legal representation before the examination under oath. A second possibility is an outright denial based on unseemly practices. If you have a preexisting condition or an on-going illness, your health insurance provider may reevaluate your policy through medical underwriters. Medical underwriters assigned a value to your policy when you signed up. After you make a health insurance claim, a bad insurance company will assign the case for further evaluation. Changing the terms of the policy after the claim is grounds for a lawsuit. In either avenue, you will receive either a denial or an offer about your health insurance claim. Again, you have the right to deny or appeal the offer. Contact your health insurance claims attorney as soon as you receive communication.

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