Denied Insurance Claims Lead To Untreated Medical Conditions

Insurance claims left unpaid create a serious problem for an injured individual who is already seriously strapped for cash. Making matters worse, in many cases denied claims by the insurance company may prevent a patient (or multiple patients, in cases of Mass Torts), from seeking out the treatment that a physician has recommended.

Attorneys have long since found (and courts have agreed time and again) that insurance companies have taken over the role of a physician, giving or denying permission for a certain course of treatment.

Although it is the right of an insurance company to deny insurance claims offered to them, they do have a fiduciary duty of fulfilling their contract with the patient. The line drawn by some insurance companies or individual representatives is at times rather murky. Those whose accessibility to medical treatment hinges on a third party’s promise to pay find they are caught between the recommended treatment and the denied financial responsibility.

As the patient opts to not receive the medical treatment they need, or as further treatment is denied by the actual treatment provider who is still requesting payment of the charges denied by the insurance claims, the disease suffered worsens. As such, the patient’s earning potential and the family’s overall ability to enjoy many of the qualities of life gradually decreases.

Children may no longer be able to participate in the extracurricular activities in which they were enrolled. A family may have to leave a beloved apartment behind and move to a smaller home in a part of town that is perhaps not as inviting or safe.

Over time, the originally denied insurance claims have an effect that permeates all aspects of the affected patient’s life. Personal injury attorneys help such patients to receive the medical care a doctor has recommended, as opposed to the medical care for which an insurer is willing to pay.

The earlier a patient enlists the help of a skilled personal injury lawyer, the sooner the potential ramifications of denied insurance payments are mitigated. In some cases the dire consequences of not having an initial claim paid may never have to materialize. Do you not owe it to yourself and your loved ones to discuss your health and insurance company with an attorney today?



Even if you have waited a long time, it is never too late to consult with a personal injury attorney and reverse the problems brought on by missed medical care.

The Law Offices of Macey & Searns will promptly address your concerns and aggressively prosecute your claim to maximize the compensation you receive. We are your partners in the mission of achieving justice for you and your family.