Medical Payment Coverage Denial

When someone is involved in a car accident, two vital questions are always asked at the scene: “Who is to blame?” and “Will insurance pay for my damages?” Nevada follows an at-fault policy with regard to personal injury.

That means someone must be found responsible for causing the accident, and the person found to be at fault must pay for all damages resulting from the accident. So what happens if you weren’t at fault for your injuries but you’re dealing with a medical payment coverage denial? You can hold bad faith insurers accountable for their actions.

What Are Nevada’s Insurance Requirements?

This type of system works when a mandated insurance policy is in place. In Nevada, drivers must follow the 25/50/20 rule for the minimum amount of car insurance.

That breaks down as follows:

• $25,000 for bodily injury to one person
• $50,000 for bodily injury per accident
• $20,000 for property damage

When a driver has insurance and is found to be at fault for the accident, their insurance is designed to cover the medical expenses of the accident victim. You might also have medical payment coverage.

Medical payment coverage insurance pays for the medical bills of you or your passengers if you are injured in a motor vehicle accident. The coverage pays for “reasonable and necessary” medical expenses, no matter who is legally responsible for the accident.

The coverage is for accidental injury to your body when you are driving or occupying an insured vehicle, or when you are a pedestrian who is hit by a motor vehicle.

In other words, whether you cause an accident or someone’s negligence causes the accident, insurance should pay for your medical expenses. What happens if you experience a medical payment coverage denial? That is when you need to involve a Reno insurance bad faith lawyer.

The Law Office of Matthew L. Sharp has experience handling these types of cases and has helped many clients prevail against insurance carriers found to be acting in bad faith.

What Are Common Unfair or Deceptive Insurance Company Practices?

Insurers may attempt to avoid or delay paying their clients. If an insurer violates specific Nevada laws, the client may sue the company for using unfair or deceptive practices. According to Nevada law, an auto insurance company in the state may not do the following in terms of medical insurance payment when a client files a claim.

Delayed Payment

There are specific timelines for processing insurance claims. Typically, an insurance carrier must acknowledge the receipt of the initial claim within 20 working days. That acknowledgment must include the proper forms and instructions. After receiving proof of loss, the insurance company must approve or deny the claim within 30 days.

If the claim is approved, the insurance company has 30 days to make the payment. Failing to adhere to that timeline could be an example of bad faith.

Misrepresent Any of the Policy’s Facts or Provisions

An insurance company could misrepresent your policy’s provisions. For instance, if the policy allows you to be reimbursed for a rental car, the insurance carrier might tell you that you’ll only be allowed $30 per day, but you’re actually entitled to $50. If you would be entitled to the difference, it must be proven.

Failure to Promptly Respond to Communications

When you file a claim, you’re entitled to updates and to have any questions answered. If the company does not respond to your communications, it is another example of acting in bad faith.

Failure to Promptly Investigate and Process a Claim

Every accident requires a thorough investigation to determine what happened and who is at fault.

When an insurance adjuster does the bare minimum of an investigation, they might conclude that you’re partially at fault. Your Reno insurance bad faith lawyer can conduct a more comprehensive investigation to determine who is truly at fault and whether they were acting in bad faith.

Failing to Give a Reasonable Explanation of Why the Insurance Payment Was Denied

A medical payment claim can’t be denied without an explanation. That explanation needs to be supported with specific details. Those details can also be disputed when you appeal the denial.

Additionally, if an insurance company gives you false information about the relevant statute of limitations, that is also an example of bad faith. The insurance company must notify the claimant in writing at least 60 days prior to the statute of limitations expiring.

Why You Need to Speak with Matthew L. Sharp

You don’t have to accept bad faith actions from an insurance company. Whether it is your insurance company or the carrier of an at-fault party, delay tactics and improper treatment are unacceptable.

If you live in Nevada and have been denied payment for medical coverage or if you believe you received any false information regarding your coverage, you should contact the Law Office of Matthew L. Sharp, a Reno attorney with many years of experience helping clients like you.

We have extensive experience successfully representing individuals whose insurance companies fail to treat them fairly. To learn more or to find out if you have an auto insurance bad faith claim, contact us today to set up a free case review.

You shouldn’t have to wait for what you’re entitled to.