Disputes between the patients and the insurance companies are very common, and it is natural. Most of the patients do not have enough knowledge about the claiming compensation process from the insurance company, and another side the insurance companies never want to pay enough compensation to the consumers. However, if the patient knows his or her rights properly and knows the proper ways of claiming insurance process then surely can get better compensation.
Suppose are an injured patient due to other’s carelessness, you should follow the below steps.
First Step: Know the Health Plan and Your Right
When you decide to call the customer service for the compensation, you must know the health plan. Some insurance plans cover a little and some covers more. You should read the plan carefully. “Summary Plan” is vital, and you should read it carefully, yes, everything is described here.
If you are an employee and your employer provides you an insurance coverage, then you should collect it from him or her and read it properly before claiming for compensation. If you are a self-insured then should ask for a copy from your insurance service provider.
After that, you should submit all the documents regarding your injury and the expenses. Their experts will study the papers carefully, and they will tell you about their opinion about the compensation. If they want to pay you less, then you can argue with all the documents, and if you are not satisfied with their decision, then you can take help of a lawyer. Again remember that the papers are vital and you should submit all the documents including the doctor’s prescriptions, doctor’s opinion, police report, etc. if you fail to provide the documents then surely you will not get the compensation from your service provider.
If you disagree with the amount of compensation then you can call for the customer service. Customer service agents have the knowledge, and they can advise you. If you are not satisfied with the customer service agents then can consult with the supervisors. They may ask you to submit all the documents such as physician’s opinion, prescriptions, etc. they can request you to submit all the documents again.
Obtain Denial Notice
If your insurance company does not want to pay you, then they should inform you by a notice, and they should tell the cause of the denial.
What To Do If They Deny Paying, Or Want To Pay Less?
It is a common question, but there is a solution. You should consult with the lawyer of an experienced law firm such as Khan Law Firm; it is a prominent law firm and has an outstanding track record. Yes, only a lawyer or law firm can help you to get maximum compensation. They will take all the documents from you and will submit to the court. After that, they will argue, and you will get the maximum benefit.