Our Lawyers Will Fight to Make Sure your Insurance Company Treats you Fairly and Provides the Best Settlement of your Life, Health or Disability Claim
Our lawyers are familiar with insurance company tactics and can fight to make sure that your life or disability claim is handled fairly and settled at the best value, or that your medical bills are covered to the fullest extent under your health insurance plan. In preparing your medical or disability claim forms, appealing claim denials, or responding to your insurance company’s informational requests, it is important to have an attorney on your side who knows your rights and can forcefully advocate in your behalf. Our lawyers routinely communicate with claim representatives, nurse claim managers, medical directors and other insurance company personnel, and, by doing so, can help to reduce your stress, aggravation and anxiety. You can worry less, and focus on your health and well being, by letting us take care of your insurance company. Some of the circumstances where our lawyers can advocate in your behalf include the following:
- Negotiating Disability Claim Lump Sum Settlement Offers: Your disability insurance company may contact you to offer a lump sum payment in exchange for all future disability plan benefits. This may happen in the context of a dispute or appeal, or may come out of the blue, after you have received disability benefits for an extended period of time. Or you may wish to initiate such a settlement yourself, to avoid the unpleasantness of dealing with your insurance company and the routinely onerous demands on your treating doctors for medical records, claim forms, and other claim documentation. We can help you to analyze whether a disability claim lump sum offer is reasonable — based on the nature of your illness, the amount of your benefit, and the strengths and weaknesses of your claim — and to negotiate with your insurance company to obtain a better settlement.
- Settling Disputed Health and Life Insurance Claims: Similar to disability claims, health and life insurance benefits may sometimes be the subject of settlement negotiations. With regard to life and health insurance claims, however, most settlement discussions occur in the context of disputed benefits. For example, a life insurance claim may be denied or reduced because of a purported pre-existing condition, alleged misrepresentations on a policy application, or because the insurance company claims that a death was not the result of an accident, but was intentional, or the result of an underlying illness. Health insurance benefits may be denied or reduced for similar reasons, or because your physician was out-of-network, or charges above the usual and customary rate, or because the treatment was allegedly not medically necessary, was experimental or investigational, or was not pre-authorized.
- Responding to Requests for Personal Information, Tax Returns, Independent Medical Examination (IME): In the context of a disability claim, you may be contacted by your disability insurance company and asked to provide information that is difficult to locate, or highly personal in nature — such as old tax returns, psychotherapy records, business diaries, etc. Or, your insurance company may demand that you undergo an “independent” medical examination, or IME, that you or your doctor find unnecessary, painful, harmful to your health, or otherwise objectionable. Your disability insurance company may threaten to terminate or deny your benefits if you do not comply with their demands. We can advise you with regard to the legality of such demands, and negotiate with your disability insurance company to ensure that all requests are reasonable and as appropriately limited as possible.
Mark Scherzer Law :: ERISA and Insurance Lawyers :: Health, Life and Disability Settlement Negotiations
New York Attorneys (including New York City, Hudson Valley, Long Island, Capital-Saratoga, the Catskills and Finger Lakes