Vietnam War Hero Denied Insurance Claim

Posted November 24, 2014

KARE11 reports that an honorable Vietnam War hero in St. Paul, Minnesota was forced to fight back against his insurer, even though he had faithfully paid his premiums year after year for long-term care insurance. His insurance company, Continental Casualty Company repeatedly denied his claims.

Jerry suffered a stroke and now has a condition called drop foot. To receive the assistance he needed, he was required to prove he had trouble with 2 out of 8 daily living activities, which he could. Even still, they denied his claim, a widower who has been restricted by his doctors from driving and many other daily living activities.

Reasons for Health Insurance Claim Denial

NerdWallet Health cites their 5 top reasons why health insurance plans may deny your medical claim:

1. Non-covered charges. This can be sneaky. Your insurance company may deny you coverage because they want you to provide more information or they may claim the care you received was unnecessary. Either way, they may deny you payment even if the care you need should be covered.
2. Referral or pre-authorization required. You may have a prescription from your doctor, but the insurance company may require you to jump through it’s own special set of hoops before they feel you have the authorization you need for your medical care.
3. Out-of-network provider – Insurance companies are very specific about which clinics, which doctors, which specialists, which hospitals and more you go to. And if you set foot in a building of a practitioner who isn’t on that list, you’re in trouble.
4. Minor errors – this may be one of the biggest headaches, because it could be any one of a million different boxes that should have been checked or lines of paperwork that should have been signed, stamped, filled out, copied or stapled, and it probably wasn’t your fault. If any bit of paperwork wasn’t filled out to the letter, your claim could be denied, and you may not have any idea what went wrong.
5. Wrong Insurance Company Billed – believe it or not, office staff are capable of filing your claim with the wrong insurance. Even though you’ve provided them with your card to copy every single time you go in to the office, they can still get it wrong, and if they do, you may be facing huge medical bills that aren’t covered by your insurance.

Oklahoma Personal Injury & Accident Claim Insurance Denial Attorneys

If your insurer refuses to treat you fairly and provide the protection and security you have paid for, schedule a free consultation so we can help. Call The Bennett Law Firm at 405.272.0303 to discuss your legal options with an experienced Oklahoma City lawyer today.