What Does the Insurance Company Consider to be an Act of God?
Insurance policies frequently use the term "Act of God" to describe events or circumstances that are an act of nature, or an event that wasn’t initiated by human activity. But what does the insurance company consider to be an Act of God? Let's take a closer look. Defining an “Act of God” An Act of God, also known as force majeure, refers to events that are unforeseeable and beyond human control. These events are typically natural disasters or extreme weather phenomena such as earthquakes, floods, hurricanes, tornadoes, lightning [...]
How Long Are You Able To Dispute Health Insurance Claims?
If you’ve ever had to navigate a health insurance claim, you know they can be complex. Disputes can arise when there are discrepancies between what a policyholder believes should be covered and what their insurance provider has approved. But how long are you able to dispute health insurance claims? Let's take a look at the timelines and processes involved in disputing claims. About Health Insurance Claims Before trying to navigate the timelines of a dispute, we need to understand the basics of health insurance claims. When you receive [...]
How Is Mesothelioma Diagnosed?
Published on May 21, 2024, by Law Office of Matthew L. Sharp
Mesothelioma
Curious how is mesothelioma diagnosed? Learn about the diagnostic process for mesothelioma, including tests, imaging, and biopsies. Mesothelioma is a rare and aggressive form of cancer that affects the mesothelial cells lining the lungs, abdomen, heart, or testicles. Due to its latency period and nonspecific symptoms, mesothelioma is often diagnosed at an advanced stage, making treatment more challenging. The most common form of mesothelioma, pleural mesothelioma, attacks the lining of the lungs and chest and accounts for about 82.1% of cases, per the Centers for Disease Control and [...]
Why Do Insurance Companies Act in Bad Faith?
Insurance is a cornerstone of modern life, offering protection and peace of mind in times of uncertainty. Whether it's health, auto, or property insurance, policyholders expect their insurance companies to act in good faith, promptly processing claims and providing coverage as promised. However, instances of insurance companies acting in bad faith are not uncommon. In this blog post, we delve into the reasons why insurance companies act in bad faith, undermining the trust and confidence of their customers. Understanding Bad Faith Before exploring the motivations behind the actions [...]
How Do You Prove Medical Negligence?
Medical negligence occurs when a health care provider fails to meet the standard of care expected in their profession. Unfortunately, these incidents occur more often than we want to believe. In the United States, medical mistakes are now the third-leading cause of death, according to Johns Hopkins University. If you believe you’ve been a victim of medical malpractice, understanding the process of proving negligence will become the cornerstone of your case. At the Law Office of Matthew L. Sharp, we know the heartache these cases can cause victims. [...]
Does Health Insurance Cover the Cost of a Stay in the NICU?
The neonatal intensive care unit (NICU) is a crucial facility that provides specialized care for newborns who are premature, have low birth weights, or face other medical challenges. While the NICU serves as a lifesaving haven for these vulnerable infants, the financial burden it imposes on families can be overwhelming. Many parents wonder whether their health insurance will cover the substantial costs associated with a NICU stay. According to the American Medical Association (AMA), "Daily NICU costs [typically] exceed $3,500 per infant, and it is not unusual for [...]
Which Health Insurance Company Denies the Most Claims?
Published on April 9, 2024, by Law Office of Matthew L. Sharp
Personal Injury
In today's complex healthcare landscape, choosing the right health insurer is crucial. One of the most significant concerns for individuals and families is how often their insurance company denies claims. Understanding which health insurance company denies the most claims can be a pivotal factor in making an informed decision about your coverage. Claim Denial Practices It's essential to acknowledge that claim denial rates can vary significantly among different health insurers. A Kaiser Family Foundation report on claims denials and appeals by health plans sold on the federal health [...]
Is a Breach of Contract Considered Bad Faith Insurance?
If you deal with an insurance company intentionally stalling a claims investigation or falsifying reasons for a denial, it could be more than bad faith insurance. Could it be a breach of contract? While both situations involve some type of breach in terms or contracts, they are distinctive from each other. We have handled many Reno insurance bad faith claims in our law office. Let's help clear up any confusion between breaches of contract and bad faith insurance. What Is a Breach of Contract? In the world of [...]
Exposing the True Dangers of Prior Authorization
In the intricate realm of health care management, few processes provoke as much frustration and controversy as prior authorization (PA). It’s a system that the American Medical Association (AMA) refers to as "costly, inefficient and responsible for patient care delays,” referring to the complexities of prior authorization as “a nightmare.” Let’s delve into the multifaceted issues, including the dangers of prior authorization, shedding light on its detrimental impacts on patients, medical providers, and the health care system as a whole. What is Prior Authorization? Also known as pre-authorization [...]
Top Mistakes People Make When Filling Out Proof of Loss Forms
After an accident, storm, or other disaster, you will want to take care of any damage to your home or vehicle. One of the first steps is to start the claims process with your insurance company by filing a proof of loss form. This document is a critical step in indicating your total losses to the insurance company. While it might seem straightforward, many people make errors on these documents. And that could lead to reimbursement delays or even a claim denial. Here are the top mistakes people [...]
