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Ohio Insurance Bad Faith Questions & Answers
1 Answer | Asked in Insurance Bad Faith for Ohio on
Q: Health insurance said they would cover a swim spa for medical reasons with a doctor's recommendation, then decides claim

All paperwork was completed and the swim spa was purchased before we knew it was being denied. Was told by insurance that they agreed they said they would pay for it, but we were given false information. They were denying the claim, even though they stated they were covering it.

Tim Akpinar
Tim Akpinar
answered on Feb 12, 2024

An Ohio attorney could advise best, but your question remains open for three weeks. One option could be to challenge the denial, whether on your own or with the assistance of an attorney. If you could arrange a free initial consult, bring the denial and accompanying paperwork, an attorney would be... View More

1 Answer | Asked in Insurance Bad Faith for Ohio on
Q: Claim denial of biopsy.

My insurance provider is denying a $43,000 prostate biopsy that was pre approved by provider with insurance. I received an estimate and paid my part up front. After much research I suspect it is because the biopsy was a transperineal biopsy instead of a rectal biopsy and may be considered medically... View More

Tim Akpinar
Tim Akpinar
answered on Sep 14, 2023

An Ohio attorney could advise best, but your question remains open for two weeks. I'm sorry for the anguish this has caused. Try to arrange a free initial consult with an attorney - this could be a complex claim that could require medical expert opinion. Gather your insurance records, denials,... View More

1 Answer | Asked in Health Care Law and Insurance Bad Faith for Ohio on
Q: My health insurance company is denying to pay hospital & ambulance bills. What type of practice area should I use?

My Insurance company says pre existing, but it clearly states within 5 years on policy we signed and it has been closer to 8 years since treatment for condition. I'm starting to get second notice bills from hospital & ambulance service. Do I start making small payments to providers or... View More

Tim Akpinar
Tim Akpinar
answered on Sep 2, 2023

An Ohio attorney could advise best, but your question remains open for a week. There are attorneys who handle health care claims. If you're considering consulting with an attorney, first review your paperwork. That could help make the most of a meaningful consult. Review your policy, review... View More

1 Answer | Asked in Health Care Law and Insurance Bad Faith for Ohio on
Q: I got mail from my insurance compancy saying they arent going to pay for the dental exams that I had already done.

I believe my insurance company covers dental exams and also i had the exams done on march 14 but the date that the insurance company mailed the letter to me was july 22, which i think is not right

Tim Akpinar
Tim Akpinar
answered on Aug 14, 2023

An Ohio attorney could advise best, but your question remains open for two weeks. Until you are able to consult with a local attorney, one option is to call the claim examiner and ask about the reason for the denial. If you consult with an attorney on the claim, that's one of the first things... View More

1 Answer | Asked in Insurance Bad Faith for Ohio on
Q: Is there a law in Ohio regarding total loss claim amounts? Given vehicle value but seeking additional costs.

Was in a total loss accident and the ins co said the settlement amount was not negotiable and only toward the vehicle’s value. Can I legally get extra money for money spent waiting on a response from them? Body shop said the vehicle should have been totaled at initial estimate but instead the ins... View More

Tim Akpinar
Tim Akpinar
answered on Nov 15, 2023

An Ohio attorney could advise best, but your question remains open for two weeks. The carrier's slow response to you is something that usually can't be included in damages. You could check with local attorneys if they see things differently. Good luck

1 Answer | Asked in Insurance Bad Faith, Insurance Defense and Animal / Dog Law for Ohio on
Q: Seeking advice on a Pet Insurance Claim. My policy covers Congenital Heart Disease. A defect occurring at birth.

My policy w/MetLife started the day I brought my Rottweiler home at 8 wks.Comprehensive Wellness & Accident & Illness.No heart murmur was heard at the 6wk check w/her breeder.I took her to her first wellness visit A heart murmur was noted but no real concern as murmurs are very common in... View More

Nicholas P. Weiss
Nicholas P. Weiss pro label Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Oct 25, 2023

You may have a claim for bad-faith insurance coverage against met-life for refusing coverage. This can result in hefty punitive damages and attorney fees for refusing to reasonably provide insurance coverage.

1 Answer | Asked in Insurance Bad Faith, Insurance Defense and Products Liability for Ohio on
Q: Do insurance companies have to pay for a rental vehicle or compensation if they fail to respond to a claim for 4 months?

I was in an auto accident 4 months ago.. The other man was at fault, but did not file a claim (I was just informed of this) for 4 months I have not had a reliable vehicle, nor have repairs been made by our insurance due to no collision policy. Our insurance did send the adverse carrier 4 demand... View More

Nicholas P. Weiss
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answered on Oct 7, 2022

Auto insurance is tricky. You don't have a claim against his insurance company. You have a claim against him. He has a claim against his insurance company if they refuse to pay you on his behalf. Your insurance company has no claim against anyone, because you did not have collision coverage.... View More

1 Answer | Asked in Insurance Bad Faith for Ohio on
Q: single case agreement not honored by health insurance company

I'm a health care provider. Several years ago I received a single-case agreement on a client. When I billed for services rendered under that agreement I was repeatedly denied for various reasons that were not applicable to the single case agreement. 20 sessions remain unpaid. This was in... View More

Tim Akpinar
Tim Akpinar
answered on Dec 22, 2021

An Ohio attorney could advise best, but your question remains open for three weeks. But it would probably be difficult for ANY attorney to advise meaningfully based on the brief description here. An attorney would likely need to see the agreement, the treatments rendered, basis for denials (medical... View More

1 Answer | Asked in Car Accidents, Civil Rights, Insurance Bad Faith and Small Claims for Ohio on
Q: What does this mean, and what do I do? Summons on Complaint. Required to serve upon the plaintiffs attorney. An answer?

I got into an accident, my steering locked up on my vehicle and I went into another vehicle pulling out of a gas station. Damaged were done and I didn't realize my insurance that I paid for 6 months in advanced had expired a few weeks prior. The other party has State Farm insurance and they... View More

Tim Akpinar
Tim Akpinar
answered on Nov 3, 2021

Only an Ohio attorney can advise here, but your post remains open for two weeks. You should consider reaching out to an Ohio attorney without further delay. I'm sorry, but from what you describe, it appears that you are being sued by the other motorist. Writing an informal note as you describe... View More

1 Answer | Asked in Insurance Bad Faith and Insurance Defense for Ohio on
Q: I had been beneficiary on daughter life insurance she passed in June & her mama got all of it somehow, what do I do

We had purchased it together when my daughter was younger, 2 yrs ago her mama said she dropped it. I am having to pay all of my daughter's debts while her grandmother gets the life insurancepolicy

Matthew Williams
Matthew Williams
answered on Apr 19, 2021

It's a little unclear what happened here, but it sounds to me like grandma bought a policy with you as beneficiary, later canceled that policy, and bought a new one with her as beneficiary. If that's the case, its her money. Were you paying any premiums? Do you have the policy documents?

2 Answers | Asked in Estate Planning, Insurance Bad Faith and Insurance Defense for Ohio on
Q: Is a surviving spouse, if they did not sign a guarantee, required to pay hospital medical bills if the deceased spouse?

My cousin passed away from cancer. Over 1 year later, his wife received a Bill from a large cancer treatment center. She had great insurance. He was receiving experimental treatment. The bill was denied because it was above usual and customary. $71,000

Beverly A Stull
Beverly A Stull
answered on Jan 23, 2021

According to recent Ohio case law, a creditor must deliver their claim to the estate's representative within 6 months of date of death. The cancer treatment center's claim should be denied.

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1 Answer | Asked in Contracts and Insurance Bad Faith for Ohio on
Q: Is the insurance co. obligated to show me the private investigators report they hiredfor a renters ins. claim?

This claim has been drug out since May and they refuse to return my calls

Tim Akpinar
Tim Akpinar
answered on Sep 27, 2020

An Ohio attorney could answer best, but your question remains open for four weeks. With most types of property damage claims, there isn't usually an issue in providing copies of, or disclosing findings of reports. It's difficult to speculate what could be causing the protracted course of... View More

1 Answer | Asked in Employment Law, Health Care Law, Insurance Bad Faith and Insurance Defense for Ohio on
Q: My employer changed health insurance companies and my old therapist is not covered. I have a bill for 3 months of visits

I’m in Ohio and my employer changed insurance companies effective the first of this year. Neither I nor my therapist realized that this change made her out of network as many of her patients have the same employer as I and I found her through my old insurance which was provided by the same... View More

Carrie Dyer
Carrie Dyer
answered on Apr 1, 2020

Your employer will not be liable to pay or waive the expense. It is your responsibility to ensure that your health care providers are covered under your employer's insurance plan. You can ask if your therapist or your insurance company is willing to work with you on payments.

1 Answer | Asked in Insurance Bad Faith and Insurance Defense for Ohio on
Q: Can I seek medical attention after the demand letter to the insurance company has been sent?

I was involved in a not at fault accident on 08/17/2019 can i send the demand letter then after that is sent go to my primary doctor for my injuries from the accident?

Tim Akpinar
Tim Akpinar
answered on Sep 28, 2019

An Ohio attorney would know best about any applicable state laws here. But your question remains open for three weeks. As a general matter, there isn't anything to stop a claimant from doing that. But a fundamental issue that could confront such a claimant if the visit to the primary doctor is... View More

1 Answer | Asked in Real Estate Law, Environmental and Insurance Bad Faith for Ohio on
Q: If a neighbor did major work next to your property line to run storm water pipes on to your property should you be told

And to find out the neighbor had been plotting this move for over a year after the head of soil and conservation advised neighbor not to block the watercourse THATS been their for 100+ years so the neighbor gets a permit to put in a WMSC and now we are getting all of the pollutions from the... View More

Bruce Martin Broyles
Bruce Martin Broyles
answered on Aug 15, 2019

Your neighbor cannot alter the course of the natural flow of water onto your property. The permits and zoning do not determine whether he has a right to adversely effect your property. You have rights that should be enforced through a complaint for trespass and request for mandatory injunctive... View More

1 Answer | Asked in Car Accidents and Insurance Bad Faith for Ohio on
Q: I was in a car accident 3 years ago. I received $900,000 from the insurance. Capitol First is not allowing access.

Capital First, will only deal with my mother. They act like she has power of attorney over me. My mother is now trying to keep half of my monthly settlement. This was done while I was still suffering from my brain injury. I no longer am, and that was proven by a doctor two years ago. I'm now... View More

Tim Akpinar
Tim Akpinar
answered on Oct 16, 2018

I don’t practice in Ohio but your question remains open for four weeks. If you were represented by an attorney, it could be worthwhile to ask them to go over the terms of your release and other closing documents for the case.

Tim Akpinar

1 Answer | Asked in Car Accidents, Insurance Bad Faith and Insurance Defense for Ohio on
Q: What are the consequences of getting in an accident without insurance?

My mom is 70 years old and had let her insurance lapse (I had no idea it had). Apparently it has been a few months. I know that it is illegal to drive without insurance. This had also happened about 7 years ago too. I thought that she was on the straight and narrow and was keeping her insurance... View More

Peter N. Munsing
Peter N. Munsing
answered on May 4, 2018

No jail. I'm assuming you had an accident. The other person or their insurance will ask for her insurance. If she doesn't have any they'll ask her to pay. It may be to her advantage NOT TO MAKE ANY AGREEMENT TO DO SO because she may be "judgement proof." It really makes... View More

1 Answer | Asked in Car Accidents and Insurance Bad Faith for Ohio on
Q: Can an Ohio insurance company raise my rates for a no fault accident? My car was struck while parked and unoccupied

A vehicle covered under my policy was struck while parked at a fast food restaurant. It was unoccupied and my step son was inside the restaurant. My insurance company is raising my rate by 29$ per month because of this. They paid nothing out for this incident, The at fault persons insurance covered... View More

Peter N. Munsing
Peter N. Munsing
answered on Mar 5, 2018

Get them to put in writing why they are doing that. Then file a complaint with the insurance commissioners office.

1 Answer | Asked in Car Accidents, Insurance Bad Faith and Insurance Defense for Ohio on
Q: Borrowed a family members car was involved in a car accident. Found out the family member did not have car insurance

I borrowed car for 1 day while car was in shop to get to work. I found out after I was in car accident due to black ice hit a parked car On the street who was parked by the curb. that the car I borrowed from a family member did not have insurance. The family member has told me they did have... View More

Peter N. Munsing
Peter N. Munsing
answered on Jan 17, 2018

But you carried insruance that covered you for liability so you should be OK. If you want, get a consult from an attorney who handles citations. Bring proof that you had coverage through your company at the time of the wreck. Notify your company.

1 Answer | Asked in Insurance Bad Faith and White Collar Crime for Ohio on
Q: I was charged with falsification documents and criminal tools. Insurance fraud. Am I going to jail?

The officer said because I cooperated that the judge would keep me out of jail because of that. But I accidently missed my court date and I had to recite myself. So does this mean that I will be taken to jail now?

Matthew Williams
Matthew Williams
answered on Aug 23, 2017

That you missed one time and had to reschedule is not going to have a major impact on the outcome. You really ought to have an attorney for this. Police officers are not very reliable sources of legal advice and often minimize to keep people calm. You need a lawyer familiar with the judge... View More

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