Florida: (407) 636-7700 California: (702) 233-3063 Nevada: (702) 233-3063

Health Insurance Disputes

health insurance disputes

Health Insurance Lawyers In Las Vegas, NV

With the exorbitant costs of medical care, surgeries, treatments, prescriptions, and even ambulance transportation, many people rely heavily on their health insurance provider to perform their duties and provide financial support following a medical emergency. After all, people purchase health insurance with the intent of securing financial coverage for medical treatment, care, and prescriptions. Unfortunately, it’s not uncommon for health insurance companies to attempt to circumvent their responsibilities to provide coverage, especially in situations where policyholders have suffered a catastrophic injury or have been diagnosed with a chronic condition.

While there are many reputable health insurance companies, some prioritize their interests, much to the detriment of policyholders. When insurance companies wrongfully deny claims or fail to perform their professional duty, they’re considered to be “acting in bad faith” and can be liable for damages policyholders have incurred.

If you suspect your health insurance provider is acting in bad faith, our experienced insurance litigation attorneys can help you hold them accountable. Contact our Las Vegas law firm, Pursiano Barry Bruce Demetriades Simon LLP, today to request a free consultation with a dependable insurance attorney!

Request A Consultation

The Responsibilities Of Health Insurance Providers

The two most common types of health insurance are individual and group health insurance. The responsibilities and obligations of health insurance providers — and the rights of policyholders to bring legal action against their provider — will vary considerably depending on whether the insured has an individual or group health insurance policy. In both instances, however, insurance companies have a responsibility to complete the following.

  • Promptly Pay Valid Claims
  • Investigate Claims Before Denying Payment
  • Provide Factual And Legal Justification For Denying A Claim

Health Insurance Disputes & Bad Faith

As with all other insurance providers, health insurance providers owe their policyholders a duty of good faith. When a health insurance company has not attempted to resolve or settle a claim, it is acting in bad faith, as the law requires insurance companies to handle claims fairly. Still, some providers ignore this duty to save money, hoping insured clients without sufficient legal knowledge or representation will settle for a low or denied claim without pursuing legal action.

Often, bad faith insurance tactics involve self-serving professional practices or gross indifference. Policyholders should watch out for the following bad faith insurance tactics.

  • Unreasonably Delaying An Investigation
  • Undervaluing A Claim
  • Unreasonably Delaying Payment
  • Using Threats To Coerce Policyholders Into Accepting Inadequate Settlements
  • Insufficiently Investigating A Claim
  • Denying Legitimate Claims
  • Failure To Justify A Denied Claim
  • Unjustly Canceling A Policy

What Damages Can I Recover?

Compensation will vary depending on whether the insured holds an individual or group insurance policy. The Federal Employee Retirement Income Securities Act (ERISA) regulates group health insurance policies. Health insurance denials can be time-consuming and challenging to appeal under ERISA laws, which is why it’s crucial to seek legal counsel from a skilled insurance litigation attorney. With the help of an experienced attorney, group insurance policyholders may be able to recover your denied benefits.

Damages an individual health insurance policyholder may recover when their provider acts in bad faith include the following.

  • The Claim’s Actual Worth, Plus Interest
  • Out-Of-Pocket Expenses
  • Damages For Emotional Distress
  • Punitive Damages
health insurance dispute lawyers

How Our Insurance Lawyers Can Help

All insurance companies should compensate policyholders for legitimate claims, and those that act in bad faith should be held accountable. The legal team at Pursiano Barry Bruce Demetriades Simon LLP can help protect your rights if you think that your insurance provider is trying to pressure you into accepting an inadequate settlement, trick you using deceptive practices, or has unjustly denied your health insurance claim. You can count on our litigation attorneys to act as a liaison between your insurance company and yourself to ensure that your rights are protected and a fair settlement is achieved. If litigation is necessary, our attorneys are capable of analyzing the policy language, gathering necessary evidence, assessing potential liability, and presenting the strongest case possible on your behalf. Contact us today to request a free consultation with a knowledgeable litigation lawyer from our firm!

Florida Office
California Office