Insurance Denial of Benefits

Insurance Denial of Benefits Attorney Serving Charleston, SC

RejectedInsurance companies often deny claims for benefits without adequate basis. For example, one in seven claims made under employer health plans is denied according to the U.S. Department of Labor. Yet around half of appeals for denial of health benefits are successful. A denial may sometimes be triggered by an error in the claim itself, however, it is not uncommon for insurers to deny adequate claims. Whether an insurance company must pay a claim is a function of the terms of your insurance policy as well as relevant state and/or federal law.

Your insurance company is required to act in good faith when resolving claims for benefits. If an insurance company denies your claim for a reason that has no basis in the facts of your case or fails to promptly settle it, it could be liable for acting in bad faith, breach of contract, and/or violations of South Carolina’s insurance code. Richard Hricik has represented individuals in numerous denial of benefits disputes with insurance companies, including claims related to everything from fire to business interruption to horse illness. Richard can help you if your claim for benefits under one of the following types of insurance policies has been denied:

  • Home insurance
  • Business insurance
  • Life insurance
  • Long-term Disability (LTD) insurance
  • Short-term Disability (STD) insurance
  • Umbrella insurance
  • Other miscellaneous types of insurance

Tactics insurance companies may use to deny a claim include:

  • Unreasonable denial, delay, or policy termination
  • Concealing benefits
  • Partial payments on disability claims
  • Insisting you are able to work in another occupation
  • Misclassifying injuries/diagnoses
  • Mischaracterizing a medical condition as pre-existing
  • Unjustifiably claiming that evidence presented by the insured is insufficient

If your valid claim for benefits under a casualty, home, business, long-term disability, life, or another type of insurance policy has been denied, you might benefit from the help of an experienced insurance attorney. Call the Law Offices of Richard A. Hricik at the number above, or use the form down below to tell us about your situation.

Resources Related to Insurance Denial of Benefits

NPR, Patients Often Win If They Appeal A Denied Health Claim

New York Times, 7 Steps in Appealing a Health Insurance Denial

Forbes, How Long-Term Care Insurers Deny Benefits

South Carolina Department of Insurance, Consumer Services