Do you have a dispute with your insurance company? Do you know how to resolve that complaint? Let us guide you through the steps to help you get satisfaction with the way your insurer has handled a claim. We have found that these steps are the most effective ways to help you work with your insurer, state insurance department, or even lawyers.
Call your insurer or insurance agent. This should be your first step if you do not believe you have had a claim paid the way it should be paid. For one thing, many problems are caused by simple errors. These errors can happen at so many steps in the process.
A medical provider, like a doctors office, may not have filled a claim out correctly. An clerk at the insurance company may have keyed in the wrong code so the computer could not arrive at the correct result. A simple phone call can help with many problems.
Sometimes your problem can be handled with one phone call. Other times, you may be directed to contact a medical office to et them to help you correct the errors. If you can resolve your problem this way, it will be the easiest and cheapest road to satisfaction.
If that phone call does not help, at least you can gather information about why a decision was made to handle a claim the way it was handled. Make sure you keep careful notes and use them to compare that decision to the wording in your insurance policy. You may find that you did not understand your policy, or you may still believe that you did not get treated fairly.
Your second step is to contact your state insurance department. Most insurance laws are set at the state level, and it is the duty of your state to enforce them. You can call or write them with your issue and they will look into them, and they will get back to you with an answer.
They may be able to help you with your problem. At the very least, you can add your complaint to a file they keep to help protect other consuemrs and possibly, change future laws. But if they cannot personally help your current situation, they should be able to direct you towards other actions you should take.
It is now time for you to decide if you need to consult a lawyer. Many lawyers will offer a free, initial consultation to discuss your problem. They should be able to tell you if you should take your problem on to court or try to settle it out of court.
Sometimes the claim will not be worth the effort, and you may have to accept your loss. Sometimes the lawyer may offer to take your case on a contingency fee basis, and so you will not have upfront costs. The lawyer will only paid if they win the case.
In any case, a legal case can cause a lot of expense and stress so you need to decide if you want to continue. Again, a qualified lawyer should help you make that decision, and you do not have to accept the answer of the first lawyer you discuss your problem with.
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