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What To Do in the Case of Unethical or Illegal Insurance Claim Denials (Part A

Insurance companies are in business to make money. They are paid premiums so they may compensate their policy holders who make legitimate claims. And while most companies act in good faith, others may behave unethically, or illegally, in order to maintain their profits.

Insurers may use practices such as rescission, miscalculation, or insurance claim denials in order to try and avoid paying you the money that you deserve.

What To Do In Cases of Insurance Claim Denials

If you have been denied a legitimate claim to compensation from any insurance provider, you should:

• Immediately read over your policy. Having an understanding of your policy rules is important as you appeal your insurance claim denials
• Call your insurer. Clarify any confusion, and ask for any information that you may need to file an appeal (make sure to document any communication you have with your insurer including the date, the name of the person you spoke with and the information they gave you)
• Gather relevant documentation, including a copy of your policy, your insurance declarations page, claim submittals, evidence of premium payments, explanations of benefits or review forms, and any correspondence regarding your claim
• Write a letter of appeal. Mail this with copies of any relevant documents to your insurer (make sure to save a copy for your own records)
• Obtain testimonies or written statements from professionals who can help you with your case

You may find that a Massachusetts insurance class action attorney can help you to determine if your consumer rights have been violated and what recourse you have in such an event. If other consumers have experienced similar violations, an attorney may find that you and your fellow plaintiffs have cause for filing a Massachusetts class action lawsuit.

It is important that you hold onto any paperwork associated with your insurance policy, including copies of the letter of appeal, claim denials and policies. These materials could prove to be critical components in your class action lawsuit. Your insurance class action attorney can provide more specific guidance on what background evidence he or she will require to properly assess your situation and potential case.

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