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Bad Faith in Health Insurance Claims

The runaround from your insurer is exactly what you don’t need when you’re in poor enough health to be filing a health insurance claim. For many people expecting to get benefits to help them through a sickness, injury, or disability, however, the runaround is exactly what they get. The insurer denies the claim, or doesn’t respond to the claim, or decides that the amount due under the policy is considerably less than what you have claimed. In the mean time, your finances are shot, you can’t get the medical or rehabilitation services you need, and your life is spinning out of control with anxiety and dread. In the worst case, your life may literally be on the line, waiting for the treatment you need to survive.

What can you do? If there doesn’t seem to be a reasonable basis to your insurer’s actions, you can get the help of an Arizona bad faith health insurance claim attorney who understands the fine points of health insurance law and will assist you in charging the insurance company with bad faith and violating their obligation to deal with you reasonably and fairly. The insurer can’t legally cater to its own financial interests and ignore your legitimate interest in getting the insurance benefits you’ve already paid for.

Why Choose Us?

Surrano Law Offices has decades of experience helping claimants with delayed, denied, or significantly underpaid health insurance claims. Insurance bad faith is the only type of law we practice. That gives us the specialization, commitment, and experience to boost the odds of success for your claim.

  • We are highly effective litigators. We have a long track record of high settlements and verdicts.
  • We understand your financial hardship. We can establish a legal fee arrangement that works for you – including a contingency fee contract.
  • We offer free consultations over the phone or at our Phoenix area law office. We can answer your questions and analyze your case at no cost or obligation.

Charles Surrano, our lead attorney, spent years on the other side of the insurance industry. He understands the unethical tactics insurance companies use to save money, and can put this knowledge to use for you. Let our law office review your case for free today at (602) 264-1077.

How Can an Insurance Bad Faith Attorney Help?

A health insurance bad faith claim can feel like a David and Goliath situation. Health insurance companies are huge and have extensive resources to fight your claim. You may not know where to begin or how to make your voice heard. Hiring an insurance bad faith attorney levels the playing field. Help from a lawyer can protect your rights. An insurance bad faith attorney can investigate your claim, help you understand the terms of your insurance contract, and establish a legal foundation for your bad faith argument. You can focus on healing from your injury or illness while your lawyer forces a health insurance company to deal with your claim fairly.

What Are My Rights When an Insurance Company Acts in Bad Faith?

It is your right to expect an insurance company to handle your claim reasonably and in good faith. Good faith refers to how an ordinary and prudent health insurance company would handle your claim in the same or similar circumstances. Good faith is the standard of care all insurance companies owe their policyholders. It means the insurance provider must process your claim fairly, honestly and with the good faith belief that it is following all applicable laws and standards of care for your situation. Any breach of this duty could constitute insurance bad faith.

If a health insurance company acts in bad faith during your claim, you have the right to speak out. You – with help from your insurance bad faith attorney – can hold the insurance company accountable for its actions and any potential wrongdoing. Bad faith is not something you have to tolerate as a policyholder. You have the legal right to demand good faith from the insurance company through one or more outlets. Once you receive a denial letter or another sign of bad faith, contact an insurance bad faith attorney.

Many health insurance companies do not take claimants’ demands seriously until they hire bad faith attorneys. The health insurance claims adjuster may assume you will back down, or that you do not fully understand your rights. When you hire an insurance bad faith lawyer, it proves otherwise. It shows you are serious about demanding good faith practices. A lawyer can force your health insurance company to reevaluate your claim by filing an appeal on the decision. Your lawyer can take the provider to court in a bad faith lawsuit to demand fair compensation. You have the right to file a lawsuit against an insurance provider for bad faith, if necessary.

A Bad Faith Filing May Entitle You to Additional Damages

A successful bad faith claim may produce damages far in excess of what you originally claimed under the policy. In some cases, you might be able to recover punitive damages and attorney fees, not to mention some compensation for that anxiety and emotional distress that dominated your life while you waited for the insurer to pay your claim.

What Amounts to Bad Faith in Handling Health Insurance Claims?

There is no limit to the number and type of actions that a health insurer can take that may amount to bad faith. The key is whether the insurer is acting legitimately—in good faith—or is simply abusing its superior position to minimize the amount of money it pays out on the claim. One common example of  insurance bad faith is the insurer using your dire need to coerce you into accepting less money than is actually due under the policy.

“Post-claim underwriting” is another common tactic for avoiding claims. Rather than investigating your application thoroughly before issuing the policy, the insurer may wait until a claim is filed then examine your application, looking for grounds to void the policy, for example by claiming a pre-existing condition that wasn’t disclosed on the application.

In medical insurance, many an insured has been told by the insurance company that it won’t pay for a treatment that the insured’s own doctors have recommended because the treatment isn’t “medically necessary.” How was that decision made? Who made it? What factors were considered and why? An experienced bad faith attorney knows where the answers to those questions reside, and how to bring them to light.

How to File a Health Insurance Bad Faith Claim in Arizona

If you suspect your health insurance company of bad faith conduct, take steps to protect your rights. The Arizona courts give you permission to file a claim for monetary damages if you can prove that your health insurer is acting unreasonably, and that the insurance company knew of this fact yet failed to correct its conduct. First, start building your case on your own. Compile a folder with all the correspondence between you and the insurance company. Keep copies of letters, emails, and descriptions of phone conversations. You should also document your medical history by keeping copies of related bills, treatments, and prescriptions.

If you wish to obtain financial compensation for the amount your initial health insurance claim should have been worth, get help from an attorney. The lawyers at Surrano Law Offices can represent you during a civil lawsuit in Arizona. We can file your bad faith legal claim, help you prove the insurance company’s wrongdoing using any available evidence, and argue for your right to fair recovery. You could receive payment for your medical bills, as well as other damages. You have two years from the date of the bad faith act to file your claim.

What Is the Time Limit for Filing a Claim?

Every type of civil claim in Arizona comes with a deadline to file, or a statute of limitations. Arizona’s statute of limitations on most personal injury and insurance bad faith claims is two years. In general, you will have two years from the date of the health insurance company’s wrongdoing to bring a claim. If you fail to meet this deadline, the courts will almost certainly deny your right to file at all. An important exception, however, is the discovery rule.

The discovery rule states a statute of limitations may toll, or extend, to the date the plaintiff discovered his or her injuries, even if that date differs from the date of the actual wrongdoing. In a health insurance bad faith claim, case precedence establishes the courts will allow the statute of limitations to begin on the date the plaintiff received a letter of coverage denial, rather than the date the insurance company allegedly began taking advantage of the insured person. You may, therefore, have two years from the date you received a denial letter to bring a health insurance bad faith claim.

Insurance bad faith claims are unique, however, in that the insurance company may have a policy in place that enforces a different deadline than the statewide statute of limitations. Health insurance companies have the right to impose unique deadlines. If your health insurance company has a deadline for filing a bad faith claim in its contract, you must follow this time limit rather than Arizona’s statute of limitations. In many cases, a policy-incorporated deadline is one year from the date of receiving a denial letter or encountering other forms of potential bad faith. Work with an attorney to understand the deadline for filing your specific claim.

Getting Legal Help is the First Step

None of these practices are new or mysterious to us at Surrano Law Offices. We’ve encountered them already in our decades of successfully protecting the rights of people under their health insurance policies. Contact us today and tell us what has happened so far, and we can explain what can be done. It isn’t a fair fight between you and a huge insurance company. Level the playing field by bringing Surrano Law Offices on board for claims in the Phoenix area and throughout Arizona.