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Claim Denied

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B

bygeorge

Guest
California. My insurance carrier has been denying claims with increasing frequency. They refuse to provide anything beyond a brochure summary as to what my coverage includes, which makes it very easy to deny claims. I have repeatedly asked for more detailed info on my policy, but they refuse. I suspect they are denying more claims to increase profits, or stay profitable... isn't everyone.

I have a difficult disease, CFS, and am on disability. The lack of predictabilty in coverage makes it difficult to pursue any treatment plan.

I want to know what my rights to know more about my policy. If I knew what was covered, I could better pursue treatment. Also, what beyond their mysterious review process, can I do to put pressure on them to provide a more transparent claims process?

I don't want coverage that I am not entitled, but I don't want to be denied coverage, because I did not play the game properly.

Please advise.
 


I AM ALWAYS LIABLE

Senior Member
My response:

. . . and, when you filed a written complaint with the California Department of Insurance in Sacramento, what was the outcome ?

IAAL
 

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