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Bellevue Washington Insurance Law Blog

Can you fight a health insurance claim denial?

Seattle residents like you rely on your insurance to help you through difficult periods in your life where you may be struggling with health and wellness. Because of that, if your health insurance claim is denied, it can feel like you have nowhere else to go. However, there are steps you can take to fight a claim denial.

FindLaw illustrates what you should do after your health insurance claim has been denied. First, you can make an appeal explaining why you believe the decision to deny your claim was wrong. This is the time to include any documents or evidence that support your side of the argument, as well. Use the grounds listed on the notice of denial you were given and focus specifically on proving that those reasons are incorrect.

Woman sues insurer for discrimination

Most people in Washington State would assume that their health insurance companies would pay for any procedures that were recommended as medically necessary by a physician. Unfortunately, this does not always happen and some people end up being forced to endure challenges due to their inability to receive the treatments they need. In some cases, patients may need to take serious steps to advocate for their health.

A woman in Oregon is today in this type of situation and, after multiple years of being denied coverage for a surgery that her doctors said is medically required, she is taking action with a new discrimination lawsuit. As reported by Oregon Live, the woman was identified as a male when she was born but early on in her life realized she was female. She has since undergone a gender transition that included taking hormone replacement therapy drugs, having surgery and making other lifestyle adjustments.

Is personal injury protection necessary?

If you have personal injury protection coverage as part of an auto insurance policy, it allows you to file a claim for damages resulting from a car accident with your own insurance company rather than the other driver's. In some states, personal injury protection is mandatory, while others make it optional. According to the Insurance Information Institute, it depends a great deal upon whom the laws of the state hold responsible for the accident.

Currently, there are 10 states that have true no-fault laws on the books. These laws limit your ability to sue the other driver if you become injured in a car accident. In each of these states, the law requires you to have personal injury protection as part of your auto insurance policy.

Are all long-term disability policies the same?

If you are one of the many people in Washington State who is evaluating your insurance coverages, you should make sure to include a review of any long-term disability policy with that. Some employers offer long-term disability coverage as part of their benefits packages but they might only offer limited amounts. Other employers may only offer short-term disability coverage options. You could consider purchasing a private policy but should pay attention to the terms as each policy could be different.

As explained by Policy Genius, one of the big differences between different long-term disability policies is the length of time you would be required to wait before being able to apply for or receive benefits. Some policies will have wait times as short as 30 days but others may make you wait a full calendar year before a claim can be made.

What does a car insurance policy cover?

Car insurance is necessary for drivers in Washington, as well as 47 other states. There are jurisdiction-specific requirements that dictate the minimum amount of coverage you must obtain.

However, according to the Wall Street Journal, the minimum required coverage may not be sufficient. To determine what is sufficient, it may be helpful for you to understand the different types of coverages that your policy may include. 

Who and what does auto insurance cover?

In most areas of the country, having at least basic insurance coverage on a car that you drive is a requirement for taking it out on the roadway. However, this is not always the case. Auto insurance laws vary by state, and while most mandate coverage, a couple of jurisdictions make it optional.

However, if you have auto insurance, and chances are that you do, it may be helpful to know what your coverage entails and who your policy applies to. This way, you can tell if you are not getting the coverage you deserve from your insurance company. 

When do you need to purchase home insurance?

You may think that home insurance is like auto insurance in that the law requires you to have it if you own a home. Though the confusion is understandable, this is actually not the case at all. If you are able to purchase your home outright without taking out a loan, there is no requirement for you to have insurance on your property. 

According to Insurance.com, it is not the government that requires you to have home insurance, it is your mortgage lender. Because most homebuyers must take out a mortgage in order to make the purchase, almost anyone who buys a home must also take out an insurance policy on the property. 

Insurance company responsibilities

People in Washington State often need to carry insurance for a variety of situations. Automobile insurance, renter's insurance and homeowner's insurance are common types of coverage purchased by individuals to protect their assets. Health insurance is another essential form of protection so that people have access to medical care when they need it. Life insurance policies, long-term care insurance plans and disability insurance plans all offer special assistance or benefits to people in the event of a difficult situation or a death. Professionals like doctors or dentists may carry liability insurance policies to protect them if they are accused of malpractice.

Regardless of the type of insurance policy, the person who is covered should always know that they have rights and that their insurance company has distinct responsibilities that it must live up to. As explained by the Houston Chronicle, every insurer is bound to act in the best interest of its client, not for its own best interest. Some policies come with clauses that provide the insured party with legal representation when a defense is needed. Other policies offer payment of any legal judgment against the insured party.

Underinsured motorist coverage

If you live in Washington State, you will know that the state requires you to have automobile insurance for any vehicle that you own. When you are looking for insurance coverage, you will learn that the state mandates minimum levels for the different types of insurance coverages. Some drivers opt to only purchase the minimum coverage levels and this can put you in a precarious position if you are hit by one of these drivers.

As explained by The Zebra, a site that provides automobile insurance quote comparisons, a person carrying the least amount of insurance possible might end up being underinsured quite easily. When a driver is underinsured, the amount of damages associated with an accident exceed the amount of insurance they carry. For example, if your vehicle is hit by another driver and the costs to repair your car add up to $20,000 but the at-fault driver is only insured up to $10,000, that driver is said to be underinsured.

How does long-term disability differ from disability?

Bellevue residents like you who suffer from an issue that has left you disabled in the long-term may be wondering what you can insurance can do for you. How much compensation can it provide? How long will that compensation last? LePly Law Firm is here to answer these questions and more today.

First, there are both long-term disability benefits and disability benefits. The latter is used to cover disabilities that are expected to be resolved eventually. Examples of this may include injuries resulting from car crashes or workplace incidents which doctors expect will heal with time. Because of this, these disability benefits usually have a set time limit.