xClaim.us

The insurance denied my claim but they failed to respond within the time period specified. Is the a default? My claim was denied on the basis that the claimed item was not covered in the contract. However the insurance company did not respond to my claim within the time period specified in the contract. Which clause in the contract comes first? They did however responded within 90 days from the first filing to their final response. Is the 90-day period a limit being upheld in a U.S. court of law?

MY claim was denied by the insurance company Is it worth taking to small claims court? I was rear ended by a driver. His house was up the street so we pulled in front of it.( yea yea i know that was very dumb, Ive heard it from everyone). But i didn't think it would matter. The insurance denied my claim because he wasn't cited. He hit me in the back regardless. Will i win in small claims court.

Has anyone else had an insurance claim denied due to study drug? We are treating a 4yr old with cancer and the insurance company has denied the claim because he is on a study drug. They were not being billed for the drug only for the hospitalization (5 rounds 4 days each). Our hospital will fight them and probably win, but I want to know if this is a new limitation on health insurance or an isolated incident.

How can I effectively appeal a denied health insurance claim? I have a series of claims ...for chiropractic treatment that has been denied....how can I get these appealed successfully? The treatment was decompression therapy...and the insurance came back and said that it's not a covered therapy.

What is the best way to file a AD&D insurance claim so it is not denied? I know ins. co's automatically deny claims. That is their job and they hope you will give up. How can I force them to actually investigate my claim without my having to jump through hoops? And what can I do up front to get them to contact doctors and hosptials regarding the claim? Sorry, I must explain.. I don't have an agent. This is a policy which was attached to a bank account. No agent was involved. I have to do this myself and it is for Accidental Death and Dismemberment Insurance. I worked for an insurance company for 20 years. Insurance companies are scoundrels. I didn't work in claims so that is why I was looking for someone who might know something about how to handle claims. I appreciate your input. Thanks. I am absolutely honest, all premiums are paid but I just really think the insurance company is going to try to balk at this claim. It is not small. That is why I think that. I am probably being overly concerned due to the fact that I have no agent to represent me and I am at the mercy of a large insurance company. But I don't think it will be a cake walk for me either. I just don't think they will try too hard to pay a large claim. That's all. I am worried I will do the wrong thing or not do enough of the correct things and they are not obligated to tell me what to do in order to be successful in filing the claim. I don't think they have to help me, do they? Is it their responsibilty to do that if they don't use agents to sell their product?

Im filing bankruptcy but auto insurance claim was denied becuase my insurance said i filed a fraudalent claim. O.k. so here it is my car was stolen back in september and my insurance denied my claim becuase they said i filed a fruadelent claim. The bank repoed my car already an now I am filing bankruptcy. Will the trustee deny my claim for the auto loan. Will someone from the bank show up at the trustee meeting and bring the information from the insurance there. Also I filed the claim in september. But the car was repoed in october while the insurance still had it. right now i owe the bank aroung 7,500. will i be responsible for repaying them. What can i do if the insurance already denied my claim.

Car Insurance Claim denied due to not having full coverage, I purchased policy online, I believed I did. HELP! I purchased a new 07 Scion Tc from the dealership in July 06. I purchased my insurance online and I didnt get an immediate quote, it had to be verified or something like that, I was assuming because it was a new car. I received an email letting me know that I was going to get a response within the next few days. I still have that email. But the next thing I received was my insurance cards through the mail. I had an at fault accident in August 06. And the insurance denied my claim statting that I didnt choose Full Coverage. I believed that was what I had. And the insurance should've made me aware of that knowing that my car was being financed. What can I do?

how can i file an appeal when an insurance claim was denied? My car was stolen and damaged, but my claim was denied because the thieves did not damage the key area of the car, they have in their policy that if a car was stolen with a key they are not responsible, they claim someone got ahold of our keys my husbands or mines and i guess magically put them back. How can i prove my car was stolen? The damage on the car was not sufficent for them, i dont feel safe driving the car, i dont know what the thieves did to it because now it wont even start, is this a lost cause?

Advice fighting a denied insurance claim by Visa for a car rental? I was involved in a solo-vehicle accident back in February 2008 resulting in my Hertz car being totaled. I, unfortunately, spoke to the police officer and there are probably 2 issues in the police report that are damaging: first is that I stated I was travelling 50mph in a 35mph zone and secondly that I stated that I "wanted to see what it (the car) was capable of." I had Visa's rental coverage (collision) with the balance covered by Hertz, but because of the nature of the accident, it was up to Visa to approve/ deny the claim. They ended up denying the claim because "damage to the rental vehicle was a result of lack of reasonable care." Now I owe Hertz the balance of the value of the car which is substantial, so I'm wondering if anyone has had similar experiences and what processes/ avenues they used to fight the denied claim. Thanks, KS

Who do you reccomend i go to to fight my home owners insurance claim roof claim which was denied? I was denied an insurance claim for roof damage caused by high winds on 04/10/08. Reason for denial, they said it was previous damage from a hail storm last year. The insurance company that denied claim is Texas Fair Plan. The hail storm that they say did the damage (one year ago), i didn't have insurance. I have major wind damage from 04/10/08. They say it doesn't matter because this roof would have been totaled out last year. Please help. Thanks again. Do know what type of lawyer would handle this type of case? Greatly appreciate your help. Have a great week!

denied insurance claim? i was recently involved in an auto accident, was at the intersection waiting to make a left. the light went yellow and still waited a sec or so and began to turn. the other driver tried to beat the light and totaled my car. even though i have the police report which says shes at fault, and on the report she claims she doesn't remember what color the light was which means she wasn't paying attention. there's also a camera on the street to prove my case, yet her insurance still denied it and said I'm at fault because she said so. i was shocked because she has all state and i thought they would handle this a little more professional, and the adjuster i talked to was being extremely rude, i know i have a solid case but my lawyer told me he needs 2 to 3 months, why would they deny it like that?

How To Fight Back When car Insurance Claim Is Denied? a guy it me on the back wen i was stop on traffic them another hit him, the guy that hit me his insurance wont paid, i'm going to make a claim also with the other guy's insurance but can anyone tell me how i can fight this myself because i have 3rd class card insurance and they wont fight it ,i wane know ifcan i do anything like take them to court myself and how or anything around these lines thatcan help(they said they dodn have to much info on the case to said that they'r at fault

Pregnancy health insurance claim denied, what can I do? I made a trip to the ER a few months ago, and to our shock the few hours that we spent there, along with tests performed and follow-up dr. visits, ended up costing over $8,000. The only thing wrong with me was that I had an unexplained rapid heart rate, which ended up being due to me being pregnant. My insurance company is supposed to pay 80% of all claims, but is now refusing to pay beyond $3000 of this claim. Reason given is that they have a cap per each emergency "condition" unless there is surgery involved. However, there is no such cap on pregnancy-related claims. All pregnancy-related claims are paid at 80% no matter what. Still, they are categorizing the rapid heart rate as a "condition' rather than pregnancy thing. All tests showed no "condition" other than pregnancy, and all drs agreed that this was related to me being pregnant. Does anyone have any idea what recourse I have for this? What chance to I stand if I challenge them in court? Anyone with first-hand experience doing this? We live in Illinois. Great responses so far, thanks so much! The other part of this is that I cannot imagine how my ER bill alone was over $6,000. Yes, I was hooked up to monitors for a couple of hours, they did some blood tests and ONE scan of my heart. I talked to an actual dr. for 5 minutes, then they released me because my heart rate was back to normal. I expected to have maybe a $1,000 bill max, and insurance would pay 80%. Sad to say, I will think long and hard next time something odd is wrong with me before I visit an ER again. This is a huge blow to us financially. sarah314, thanks for your answer. Now they are telling me that all my ER expenses except for a tiny misc. ER amount are considered "outpatient treatment" and are subject to the $3000 limit. Yet they show benefits for hospital ER as including "staff physician, us of ER supplies, necessary emergency treatment" as being paid at 80%. The policy is confusing, and so far nobody will tell me how to protest the claim.

Im filing bankruptcy but car insurance claim was denied becuase my insurance said i filed a fraudalent claim.? O.k. so here it is my car was stolen back in september and my insurance denied my claim becuase they said i filed a fruadelent claim. The bank repoed my car already an now I'm filing bankruptcy. Will the trustee deny my claim for the car loan.

Im filing bankruptcy but car insurance claim was denied becuase my insurance said i filed a fraudalent claim. O.k. so here it is my car was stolen back in september and my insurance denied my claim becuase they said i filed a fruadelent claim. The bank repoed my car already an now I'm filing bankruptcy. Will the trustee deny my claim for the car loan.

Injured at work before shift, insurance medical claim was denied, now am stuck with bill. What to do now? Even after the incident, was told by my management that it would be in my best of interest to go to the E.R and miss work that it would be covered. Just got in the mail that the claim was denied and I am responsible for the medical bills, which includes at least 4 x-rays. Should I hire a lawyer or what?

Will any benevolent solicitor/lawyer take on my car insurance claim and defeat a mighty car insurance co? I was 100% innocent in a car accident. My insurance is 3rd party only so I have had to make a claim myself against the other drivers insurance co. They have denied my claim saying the damage doesn'y fit how I described the accident. Basically the damage does fit the description because that is what happened! How can little me fight the mighty power/legal dept of one of the UK's biggest car insurance companies? I can't of course. But I want to win because I want my money back for the damaged (and now useless) car and for the principle of the thing and because I am sick to death of being trodden on my huge corporations, just because they can do it to us. It wouldn't be cost effective to hire a solicitor to help out as I'm only looking for something in the region of £400 to £600 damages. Has anybody got a few spare minutes to take my case on and put one over a megalith company?

Insurance Claim Denied: Dr. Not submitting Paperwork.? Between August and September I went to see my doctor due to heart palpitations. The symptoms are gone now, but since i was with a new insurance company (Horizon Blue Cross Blue Shield of NJ) they required the doctor to send in a preexisting condition questioner. The insurance company has yet to receive the questionnaire and therefore the claim is denied for preexisting condition pending the questionnaire. I spoke with the doctors office on this about 2 months ago after receiving threats of them contacting a collection agency. After several phone calls, all of which the doctors office was being very belligerent, they finally apologized and realized what the problem was and said they would correct it. Today I received a call from them saying the insurance company denied the claim and it was now my responsibility. Sure enough, after contacting the insurance company there was no action done since the questionnaire was not submitted. Does anyone know what my responsibility would be? I am under an HMO plan and the insurance company has a contract with that doctors office. It seems like the doctors office is going to start denying responsibility again and pressuring me for payment. Obviously I don't want to pay them since there would be no incentive for them to submit the paperwork. But i also don't want to wind up going into collections.

How do you get a health insurance company to pay for a claim after it was initially denied? My wife was having severe headaches and feared she had a serious medical problem. I took her in to the emergency room, they gave her a shot and a perscription and diagnosed it as sinusitis (sp). The insurance company is claiming the visit was unneccesary. To me, it seemed a necessay precaution. What can I do to get them to pay up? I'm in Pennsylvania. The company is Health Assurance. I changed jobs so I am no longer with them. They stated that the ER visit was unnecessary because the condition existed for 10 days prior. However, her condition became very severe on the night we went to the ER and our primary care physician was not available to see her. They did give her a shot for her pain that night at the ER which should serve as evidence that she was in intense pain. Also, I do not have a copy of the medical records from that visit but I am calling the hospital tomorrow in order to obtain those records.

Auto insurance claim denied in the middle of investigation, what next? Recently my boyfriend and I were leaving Wal-Mart, and as soon as he was about to shift into drive after backing out of the parking place, a woman back out of her parking place right into the rear corner of my car. We had a police officer come and write out an exchange information sheet, he couldn't do much more than that because the Wal-Mart parking lot is private property. The woman admitted she didn't see us when she looked left and right and that she didn't look behind her, but she wasn't sure who was at fault. The information sheet had an agreed statement of that she backed into my car while my car was already in the aisle, so I proceeded to call my insurance company. We found out that the woman and I both had Nationwide insurance. I had my damages estimated, and then I didn't hear much from our adjusters for a while since my boyfriend was the one driving. When I finally heard from them, they said they couldn't get the surveillance video from Wal-Mart, even though Wal-Mart told my bofriend and I that they could and Nationwide refused to try any further. They said that since they couldn't prove 100% that the woman was at fault and there was a possibility that my boyfriend was even 1% at fault that they couldn't accept the claim and still refused to try and find out who was really at fault. I later found out that the woman told the insurance company that we backed into each other even though she agreed on the police statement and apparently didn't even know what happened at the time, and Nationwide refused to care that she changed her story for them. I asked my adjuster to ask her permission to give me her phone number and that they needed to get the video, and randomly I got a letter stating my claim was denied even though I was no where near done with the investigation and never heard back from my adjuster after a week and a half. The adjuster was not very professional at all, he didn't seem to want to do any work for his paycheck and he was even crying on the phone after my boyfriend politely told him he knew how insurance companies work but that for the prices we pay each month, insurance representatives should at least try to do their job. What am I supposed to do now? I refused to have any work done to my car until everything was settled. I left my adjuster a message to call me back a few hours ago and stated that I was not done with the claim and if he couldn't handle his job, then I need his supervisor's number or someone who could handle it. I'm entirely disappointed in Nationwide's complete lack of customer service and I shouldn't have to pay to fix my car when someone else backs into it. The letter denying the claim said that my boyfriend failed to keep a proper lookout when backing. The woman was apologizing profusely when it happened. The insurance company contacted the officer and he said the exact same things I've mentioned. This is in the state of Virginia. (I apologize for so much writing, but I didn't want to leave anything important out.) The Wal-Mart parking spots are at an angle, so from the angle we were at -- not quite parallel to either the spot or the aisle -- while we were about to straighten out, it's pretty obvious that she backed into us or my car would have had to move sideways to hit her like that.

Hurricane Katrina victims are are having their claims denied because fact they had no flood insurance. Fair? Homeowner victims of Hurricane Katrina have been denied their insurance claims due to the fact they had no flood insurance on their homeowner policy. In other word their insurance they paid for all of those years was worthless. Doesn't the title "Huricane Insurance" emply flood coverage?

On what grounds might an insurance claim be denied? Accident, Automobile

Panic/Anxiety & Depressive Disorder Disability claim with Private Insurance company denied. Advice please? I am suffering from a panic/anxiety disorder which has brought about severe depression. I have been unable to concentrate, eat, sleep, work, or socialize with family or friends. I am seeing a therapist & we are working my way out from this black hole. My question centers around the STD disability claim that I filed w/my employer's insurance company. They denied my claim citing lack of comprehensive doctor's notes to support the diagnosis; and they also said that I've been able to go to school without missing any classes (which is not true...I've had to fight to get to class and class is only 1 hour long, 3 nights a week...vs. work which is 8 hrs, 5 days). So, my question is....has anyone else been denied from their private insurance carrier for STD due to anxiety &/or depression? And if yes, what would you suggest I do from here to get them to reopen my claim & approve it? NOTE: Anything you can provide regarding my claim would be helpful. I only ask that everyone be kind.

My Insurance denied accident claim...What can the other drive do now? Last week a lady filed a police report claiming I hit her parked car. I never felt anything backing out and there was no damage done to my car. After speaking with the cop I called her asking to get an estimate of the damage and if there was major damage I don't believe it was my car that could have done it. Got the estimateof $941. I called my insurance and they had two adjusters look at her car and mine. They said the amount of damage done to her car would have caused damage to mine so they are denying the claim. She is telling the adjustor that I told her I might have done it and stuff about my car looking polished in the front and that might be the point of impact. I told her from the beginning I wanted an expert to examine the cars and I would take responsibility only if I knew for sure I scratched her car. This woman is trying whatever she can to have her car fixed. What can she do now to try and get me to pay for her damages? Is it likely that someone will make me pay?

How many health insurance claims are denied in the US each day? I'm working on a documentary about health insurance claims, but can't seem to find a solid statistic about how many (potentially life-saving) treatments are prevented by the insurance claims that are denied by companies. A daily or annual figure would be hugely helpful. (This is only a minor fact to contextualize an individual's struggle with the healthcare system that is the actual focus of the film).

What to do in an Auto accident, not my fault, other parties insurance denied my claim.? I was recently in an accident. I was at a four way stoplight, my light had just turned green when I noticed to my right that a local police officer had his lights and sirens on and was going to cross his red light. I yield to allow him to pass. I only moved 2-3 feet forward before I yield. At my red light there was no vehicle behind me. Once I yield I was rear ended by another vehicle. Police officer witnessed everything and stated it was the other person's fault. I filed claim against his insurance, but they denied the claim because he was not listed as a driver in the insurance. My wife and I had to get ourselves checked out at a hospital. My car has damage, and we have medical expenses. What can we do, I only had liability insurance. The other person had no license and I believe a minor. Thank you. Im in Texas by the way. Any possible way to make a claim against the city police? I was yielding for them to go through, and that is how I got hit.

I need to file an insurance claim on my house, but my house is currently for sale. Will I be denied? I spilled a chemical on my carpet, and the insurance company is sending someone to look at it. I currently have a for sale sign in my front yard. Is there any chance of this getting approved, or will I automatically get denied?

Health insurance claim denied despite proof of coverage? To make a long story short, I have several claims from summer of 2007 that are being repeatedly denied by my ex-insurance company due to their claims that I was not covered for those dates. My previous employer (a large well-known international retail business) has both been on conference call with me and sent a letter in writing to the insurance company clarifying my coverage dates. The claims are still being denied. When my HR dept is open again I will make one more call to ask them to verify, but if this denial occurs again, what are my options? Should I compile a bunch of paperwork and send it to a higher up at the ins. co? Should I be hiring a lawyer? The insurance agent clearly expressed doubt on the phone WITH my benefits department regarding their records. They obviously do not want to take responsibility for these bills. I've wasted so much time going back and forth with them...help! Here's the ironic part. A conference call was already made prior to my second denial. The rep blatantly doubted my employer's records, but said records would be updated. My employer also followed up with a written statement of coverage. Denied again. Then, I was informed they would call my employer and I also sent them paycheck stubs showing I was paying for insurance. I was told following their phone call to my employer, they would personally respond with status, which never happened.

What Can I do if an insurance company denies my claim due to a dispute of who was at fault? I was rearended in a car accident on the highway. The other driver claims she was going the same speed limit and I "cut her off", but there were skid marks 100 yards long indicating she wasn't able to stop in time because she was going to fast to stop. Dallas police would not come to scene of accident because there was no one injured. Her insurance company denied the claim because there was a dispute at who was at fault. What can I do??

Insurance denied ER visit claim, stating non-emergent situation? My insurance recently denied my ER visit claim, stating that the code from the hospital billing is not considered an emergency, and the doctor's notes support a non-emergency. I am fully aware that there is a prudent lay-person clause, and I stand by my decision that I should have gone to the hospital, I truely believed my health/life was at risk. I have filed an appeal with my insurance company, but am really worried they will continue to deny the claim and I will be stuck with the hospital bill. The funny thing is, the insurance company was billed seperately for the blood work and doctor for this same ER visit, and both of those claims were paid by insurance. They are only denying the hospital claim, which of course is the most expensive. I know I can file a second appeal if my first is denied. What should I say or do to have my appeal accepted and claim paid???? The hospital refuses to bill using a different code. Just to let you know my symptoms, I woke up after being fine the day before, unable to move. I needed physical assistance getting out of bed. Every joint in my body hurt when I moved. Then I discovered that I had a rash head to toe to go along with this excrutiating pain. The hospital billed my insurance for "joint pain", and this is what the insurance is telling me that the "joint pain" is not considered an emergency. Personally, I thought I had meningitis.

when a insurance claim is denied, and you prepare for trial, how much time will it take?

What happens to someone who files a false insurance claim? I was with a friend who got in a very minor accident (everyone was fine). No police report was filed, but the other driver made a claim to her insurance company that she had serious medical problems as result of the accident (she had a handicap sticker in her car so we knew she had existing medical issues). My friend's insurance company denied the claim since a third car was at fault (and they knew from the damage that her "injuries" weren't from the accident). What's the likelihood the insurance company will do anything to that lady for making a false claim? Or can people just claim whatever they want to try to get away with it? We were all stopped waiting at a light and the car behind us bumped us (which caused us to bump her). Not even 5 mph, and her car didn't even move six inches. I'm 100% sure she was not injured in any way. It just surprises me that if someone obviously makes a claim with the intent to commit fraud that the insurance company would let it go. The ins company wasted a lot of money on a mechanic and a claims person to investigate this (only to find out it is was a false claim). Why wouldn't you raise someone's premium for costing you so much money?

I have GMAC homeowners insurance and was just denied a claim for hail damage. Anybody else have a bad exp.? My house does have hail damage. Every single house surrounding me, including all but 2 houses in a 4 block radius, were approved to minimally have their roofs replaced. A lot of people are getting their siding replaced as well. I can not even get them to send out a second adjuster to see if they possibly made a mistake. I am very frustrated. Has anybody else had a bad experience with GMAC homeowners insurance? To me the claim is such a no brainer. And every single day I get to walk outside my and see how badly my insurace company has judged this claim. Any ideas on how to get this claim approved? You asked for more details. I have a $500 deductible. I have received the denial in writing. It states there is no hail damage to my roof just normal wear and tear. Although they did find hail damage to some faschia, some vents and my deck, which totaled $800, so I received a $300 check in the mail. Which I asked them not to send me because I do not agree with their estimate. And I am not kidding you I walked around the 4 block radius this past weekend and talked to every single neighbor who was out and I could only find two other people whose claims were denied. The houses are not fine, but their insurance is also denying their claims.

What do you call the person who denies insurance claims? The person who reviews policies in the insurance industry and denies claims. Thanks!

Insurance denied claim, HR says "benefit limitation", legitimate medical need (flat head) Who to contact now? Our son was born with torticollis (head severely tilted to one side) which lead to plagiocephaly (head flattened on one side). We contacted insurance to see if they would cover a helmet (DOC-Band) for him. They denied it, saying it was a plan limitation...they will not cover any cosmetic items that reshape the head. So, my wife and I paid $2700 out of pocket for the helmet. Now, he is 10 months old and has had more ear infections than we can count. His pediatrician noted that his head shape has reverted to being flat, and that may be contributing to the ear infections. She wrote a letter of medical necessity for another helmet, which the insurance company denied, repeating the plan limitation. The appeal also denied, and the appeals dept. suggested we contact my wife's benefits dept. The benefits dept. said there is nothing they can do, but I cannot believe that. The doctor says medical necessity, it should be covered, end of story. Is there a watchdog group we can contact? We are in Texas, if that helps. We have already appealed and been denied again. They continue to assert that my wife's employer is holding them back from approving it because the plan that they offer their employees will not allow for it, "benefit limitation" they call it. Can anyone tell me *exactly* who I should contact after being run in circles by both the employer and insurance company? Found it. Texas Department of Insurance. Thanks Jill B...a winnar is you.

does a car insurance company put a denied claim into a computer system?

Denied affordable adequate health insurance/denied claims,moral question? Is it a violation of your rights if someone or a company endangers your life by keeping you away from something that could save your life?People loose their homes paying for doctors bills either because they were denied a policy or could not afford to keep it. The waiting list for adult basic is in the hundred thousands and that's if you qualify.

The evil insurance company denied my claim should i sue them? my house burnt down in a fire and they refuse to give me the money to rent a house

can i fight a denied life insurance claim? My mother had life insurance, when she died i was denied those benefits as she had drugs in her system. However her death was ruled as drowning, which is considered accidental not suicide, even tho the drugs were in her system she was breathing and the drowning is what lead to her death.She suffered from depression and these "episodes" were common and often ehr way of reaching out for help, in fact the few letters that were found were all addressed using future tense, such as one to a Dr which stated could we try (a certain type of therapy). These notes make it obvious that she had not planned on dieing as they all address her life in the future weeks. Can I fight the insurance company?

Claim denied by Insurance? Had Builder's Risk Insurance, this insurance is for construction of residential house, the foundation wall collapsed during 3rd day, the foundation wall was not build as per plan, i had to sue builder, architect and surveyor. my insurance company denied the calim. i though they will pay to repair or rebuild and then recover or sue my builder. they also denied to pay me rent even though i had loss of use of property coverage. any way i can collect the claim to rebuild, repair foundation wall or rent i pay till the wall is fixed.

Can an insurance company deny you a claim if the other party is legally guilty? I got a letter stating from the other insurance company stating I was at fault because I drove around the semi which is far from the truth. This was a rear end collision so by Iowa law, he was at fault and got a ticket. He tried to contest his ticket giving this such reason and lost, even with a defense lawyer. Given the fact that a judge didnt believe him because he wasnt 100% sure if I came around him, can an insurance deny you a claim and say the majority of fault is with me. Well the real reason they denied my claim was because I told them I had a whiplash as a result of the accident and was still seeking treatment. I'm getting a lawyer to resolve this issue, but how can an insurance company determine fault when legally you werent at fault? The only thing I left out here is I did contact them by email stating my disapproval and the reasons I was hiring a lawyer only because I didnt want them going around telling my chiropactor and my insurance company that this case was over. I just gave him some points to ponder and that he could direct further questions to my lawyer. Well the case is a failure to stop assured clear distance, which means I was stopped at a stop sign about to make a right turn when he didnt slow down to comply with the stop sign. But also the guy insured with them agreed to pay damages to my vehicle to which he did. Thats the case at hand. This just in, they magically found new evidence that said his case was upheld by the court. But I'm still seeking legal advice because their offer was bogus.

If I am appealing a denied Unemployment claim, how can I know what my former employer claimed about me? I just found out that I was denied an Unemployment Insurance claim and will be appealing the decision. After reading the U/I laws, it says in Section 1327 that my former employer has to submit a written response as to why I don't deserve my benefits. In order to better write my appeal, I need to know what was written about me, and what they are claiming I did. Do I have the right to get this information, and how do I do so? I just found out that I was denied a California Unemployment Insurance claim and will be appealing the decision. After reading the CA U/I laws, it says in Section 1327 that my former employer has to submit a written response as to why I don't deserve my benefits. In order to better write my appeal, I need to know what was written about me, and what they are claiming I did. Do I have the right to get this information, and how do I do so?

What should I do if the Auto Insurance denied this claim? On May 24, the driver of the vehicle insured by Titan Auto hit my parked car in the early morning. He was arrested for drunk driving. The driver was not the owner of the car that hit me and the insurance is under the owners name. Titan said they had to contact the vehicles owner to make sure they had permission. Repeated calls to the adjustor in the last few weeks were not returned so I had to contact her supervisor numerous times to obtain information for my claim. Titan has now denied my claim. They say that since they can not find the owner or driver of the vehicle that hit me, they will not pay for the damage. There is a police report. The insurance company has a copy. The car was not reported stolen.

Can health insurance deny claim after pre-authorization How likely is it & under what circumstances can a health insurance company deny a claim if they had pre-authorized the treatment earlier. The specific case I am concerned about is cancer which was never diagnosed or symptomatic but may be determined to be pre-existing after surgery. The insurance in question is short term visitors insurance from a leading US insurance carrier.

The USPS denied an insurance claim and 1st appeal. Item good before shipping. Item damaged during shipping.? The clock was packed with at least 3 inches of packing peanuts on all sides. The outside of the clock was not damaged A clock inside had an 8 ounce metal gong broken off its post. There was definite damage to the outside of the box. The box was crushed on the top end like an accordian. The USPS denied the claim and the appeal. Photos were sent showing the damages. Damage claimed is $75.00 the value of the clock. It will cost $100.00 to repair. What should I do next as this seems completely unfair?

claim insurance rep. told me that my claim will be most likely denied...!? I had an accident a week ago. Since it wasn't my fault, i went to make a claim with the guy's insurance company. today ( a week later), i called the guy's insurance, they told me that the claim is most likely going to be denied because they hadnt able to get a hold of their customer ( the person who's at fault). He went on and tell me that i should really make a claim with my own insurance because there might be coverage issue. Moreover, he told me that my claim will be denied for sure if they're not able to get a hold of the person who's at fault by tomorrow. My question is "can the guy's insurance company denied my claim when there's a police report that states clearly that I am not at fault?" and "what are the consequences for the guy (person at fault) ?

after an insurance claim is denied how long will the it take to go to trial?

Have you ever heard of Qualification at time of claim? How can Insurance companies deny a claim like that? How can an insurance company deny a life insurance claim after a person has put good faith in that company by paying their premiums? Isn't that illegal?

Travel Insurance claim- Denied? My father came from india to US, he had travel insurance. Suddenly he got stroke, admitted to hosiptal in US and he was taken back to india and he is continuing the treatment. Now the insurance rejected $80,000 claim since it was pre-existing condition (it was his three stroke). Now i dont have that much money since i came to US couple of years back. Hospital and Doctor office are sending receipts to my address...saying if i didnt pay it will goto collection agency. Letters & receipts are coming in my father name. Any suggestions to solve the issue.

Do I need to hire a lawyer to fight against health insurance company for denied claims? I am having problem with my health insurance company who denied coverage. There is $50,000 outstanding balance, which supposed to be covered, but were denied, because of I am also listed under my husband's health insurance. The claims were re-routed to both insurances.... and I haven't contacted the State agency (Dept of Insurance?) yet. On the State agency's web site, it saying "If you have an attorney representing you in this matter or if there is a lawsuit currently ongoing or pending, our ability to mediate this matter is limited, but we will investigate your inquiry for any regulatory issues. However, if a lawsuit is pending, we may defer the regulatory investigation until the finality of the litigation. We ask that you still complete this form so we have a record of your issue." The original service was rendered 6 month ago... and I am losing time. Shoud I file a complaints to State agency first, and wait for what they are come up with? OR hire an attorney now?

Medical insurance denied the claim and not much help form provider. Almost cornered to pay. Need help.? My Insurance denied a cliam for a doctors visit, saying its not covered by the company. I was acutally refered by another doctor to this guy for excessive sweating. when I book the appointment they took my insurance details and said all I need is to pay copay. Now they are after me asking for 250 just for a visit. I talked to my insurance how can they deny it..it was just a visit and Doctor visits are covered in the plan. It would make sense if I go for further treatment and services for a thing which is not covered and they said if they put a different reason code they can authorize and provider didnt check with insurance before my visit and not willing to change the code or help in any matter. I am cornered me to pay the money which I dont think I have to pay. Help appreciated. Adding details: I was refered by a specialist.(In network doc but not primary physician) to the specialist who is also in network. Insurance company says the claim code or diagnosis/illness is not part of my benefit. in network physicians and specialits are covered though.

Can an insurance company deny a claim due to lack of timely filing by the provider? I recently received a letter in the mail from my provider stating that I was about to go into collections for a surgical procedure that I had done in 2005! When I contacted my insurance they said that the provider did not file the claim in a timely fashion and now I would have to pay it. I went back to the provider and they had ample proof that they had made attempts to bill the insurance. The insurance said none of that matters now and that Im pretty much SOL. I filed an appeal with my insurance which was also denied. The provider said that Im just now receiving the claim because the insurance continued to correspond with the provider and so the provider thought they would reach resolution. Is there any laws to protect me the consumer from getting stuck with the bill?