According to the Association of Air Medical Services, more than 550,000 people receive airlift services every year in the U.S.
While some are pre-planned and coordinated to transport patients between medical facilities, the majority of airlift situations are due to accidents and emergencies.
Many people who have coverage through their employer, a self-insurance plan, Medicare, or Medicaid may assume that these services are included in their policy.
It comes as a shock when they receive a bill and must pay out-of-pocket because their claim for an airlift is denied by an insurance representative.
However, there may be many factors that determine your entitlement, or lack of it, so don’t accept a denial at face value.
Here are some reasons why you should contact a knowledgeable insurance disputes lawyer when your medical insurance won’t cover the cost of your airlift.
Insurance Companies are Businesses First
You may pay your premiums regularly, and thus expect proper customer service from your insurance company. Still, an insurance company is a business first and foremost.
These companies are motivated to maximize profits and minimize losses, and your claim for the cost of an airlift may be viewed by your insurer as another potential disputed item. They may deny your claim for airlift because they do not expect much of a fight if you do not have a lawyer.
Insurance Representatives Do Not Work for You
The National Association of Insurance Commissioners reports that the average cost for one air ambulance flight is between $12,000 and $25,000. Insurance companies often do all they can to avoid payment of a claim for this high amount, so they frequently put their best claims employees on these matters.
Even though they are not attorneys, insurance company representatives have experience and in-depth knowledge of the law. They may seek loopholes, assert that the transportation was not medically necessary, or find other reasons to find that an airlift is not covered. You are at a disadvantage unless you have a lawyer to fight for your rights.
An Attorney has the Legal Experience and Knowledge to Protect Your Rights
A lawyer with experience in insurance disputes knows the laws that protect you from potential misconduct by insurers. In California, insurance companies have a legal duty to act in good faith in processing your claim and in settlement discussions. Failure to do so can be bad faith, for which insurance providers can be liable. You may be entitled to compensation if the insurer’s refusal to pay for your airlift claim involves:
- An unjustified denial;
- Refusing to pay before proper investigation;
- Not paying the claim within a reasonable time period;
- Failure to attempt to settle or offering substantially less than what the claim is worth;
- Refusing to participate in settlement discussions;
- Failure to provide a reasonable, supportable explanation for denial of the claim; and,
- Many other like examples of misconduct.
Consult with an Experienced Insurance Disputes Lawyer
For more information on bad faith and other tactics an insurance company may use to avoid payment of your airlift, please contact GJEL Accident Attorneys. Our lawyers have extensive experience protecting the rights of insured individuals, and we will fight for your rights when confronted with misconduct.