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Your Information Source for Insurance Coverage Denials & Disputes

13/10/2023

If you’ve had a negative experience with your health insurance in the last year, you’re not alone. A recent survey found most people did, most often with health insurance claim denials that they couldn’t resolve on their own. Learn more about the KFF survey results.

Non-profit health policy organization KFF conducted a survey of consumer experiences with health insurance, & denied claims topped the list, not in a good way.

12/09/2023

Prudential got dinged by the Department of Labor for denying supplemental coverage based on lack of evidence of insurability.

Learn what Prudential did wrong.

Prudential Life Insurance agreed to change its practices after a DOL investigation found it unlawfully denied hundreds of supplemental claims for lack of EOI.

05/08/2023

HHS required hospitals to publish their prices for medical services, but hospitals refused and sued. They lost, and now some in Congress wants to make a law. Read about the PATIENT Act and attempts to force transparency in pricing.

A new bill in Congress would force hospitals to publish their standard charges for shoppable medical services like colonoscopies, after lawsuits against rules.

07/07/2023

Common reasons for life insurance denials include misrepresentation on the application, the contestability period, and bad faith practices.
Learn more about these common reasons for life insurance denials in our latest blog post.

Common reasons for life insurance denials include misrepresentation on the application, contestability period, and bad faith practices.

01/06/2023

If your insurance claim is denied, you have the right to appeal the decision made by the insurance company.

In our blog post, we cover some of the requirements of insurance companies and your rights regarding health insurance denials under state and federal laws.

If your insurance is improperly canceled, or if the insurer refuses to pay a claim or ends your coverage, you have the right to have that decision reviewed by a third party.

28/04/2023

While brokers and agents are human beings, they may have varying levels of competence and conflicting interests.

Our latest blog delves deeper into the legal obligations of insurance brokers and highlights instances of misconduct. Learn more in our latest blog.

Insurance brokers can be held liable for damages they cause through their misrepresentations, whether through negligence or fraud.

02/04/2023

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.

Learn more about these steps and what you can do in our latest article.

A report finds Medicare Advantage insurers deny a disproportionate number of claims. Learn what you can do.

07/03/2023

You might have been denied coverage because your agent did something wrong at the time of filing, during the investigation process, or because they negligently misrepresented your policy coverage at the outset.

In our blog, we discuss what insurance agent negligence is.

Insurance agent negligence can arise when your agent makes mistakes that lead you to believe you have coverage when in fact, you don't have it.

09/01/2023

Servicemembers Group Life Insurance (SGLI) is a life insurance policy available to servicemembers to help ease the pain and financial hurdles experienced by their families due to their passing.

In our blog, we explain various important facts about SGLI policies, claims, and denials.

Servicemembers Group Life Insurance (SGLI) is a life insurance policy to help ease the financial hurdles experienced by their families.

07/12/2022

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.

Learn more about these steps in our blog post.

The steps for fighting a health insurance claim denial include figuring out how to appeal the claim and determining if it's governed by ERISA.

04/11/2022

Insurance companies are required by law to notify the policyholder of a missed payment and their right to make up the payment within a grace period.

Learn more about what else beneficiaries can do if their life insurance policy lapses.

Insurance companies are required by law to notify the policyholder of a missed payment and their right to make up the payment.

24/10/2022

Insurance disputes often arise over whether a proposed procedure fits within the definition of cosmetic or reconstructive.

Learn more about cosmetic surgery and medical necessity in our blog post.

Insurance disputes often arise over whether a proposed procedure fits within the definition of cosmetic or reconstructive.

14/10/2022

Social Security Disability Insurance (SSDI) is a monthly benefit paid by the federal government. On the other hand, long-term disability (LTD) insurance is optional insurance that not every worker has.

Learn more about the differences between LTD and SSDI.

Social Security Disability Insurance (SSDI) is a monthly benefit paid by the federal government. LTD is optional insurance that not every worker has.

12/09/2022

A whole life insurance policy builds value the longer you own it. If you cancel the policy before using it (i.e., if it expires before you do), then you are entitled to the cash value built up in the policy.

Learn more about whole life policies in our blog post.

A whole life insurance policy builds value the longer you own it. If you cancel the policy before using it, then you are entitled to the cash value.

02/09/2022

If your health insurance claim denial was wrongful or in bad faith, you can get the benefits you are entitled to. Additionally, you can recover compensation for any other damage caused by the insurance company’s wrongful denial.

Learn about why some health insurance claims are denied.
https://www.insurancenewsdesk.com/why-some-health-insurance-claims-are-denied/

Some health insurance claims are denied on the basis of medical necessity, experimental, or investigational. Learn more about each.

17/08/2022

Group life insurance denials can arise around the issue of not "actively working" at the time of death.

Learn what this means in our blog post.
https://www.insurancenewsdesk.com/group-life-insurance-only-pays-those-actively-working-at-time-of-death/

Group life insurance only pays those who were "actively working" at the time of death. This raises the question of what it means to be “actively working”.

05/08/2022

On July 20, the SEC announced that it had filed charges against a health insurance company for hiding a list of consumer complaints from the company’s investors.

Learn more about what happened in this case in our blog post.
https://www.insurancenewsdesk.com/what-insurance-companies-do-with-consumer-complaints/

According to a press release issued by the SEC, HII lied to investors during multiple earnings calls and presentations to investors.

12/07/2022

Deferred annuities are often aggressively marketed to consumers, especially elderly consumers, but some would say they have become the scourge of the unwary investor in recent years.

Learn more about deferred annuities and some of the scams that can accompany them.
https://www.insurancenewsdesk.com/are-deferred-annuities-for-real/

Deferred annuities are often aggressively marketed to consumers but some would say they have become the scourge of the unwary investor in recent years.

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