Annandale, VA asked in Consumer Law and Insurance Bad Faith for Virginia

Q: A medical insurance claim was denied, can you help us with the appeal.

My mom suffered a stroke while visiting the US. We bought her a travel medical insurance before her travel dates, but the insurance claim was denied while she was in the hospital. We are trying to file an appeal against it as it falls under their clause "acute onset of preexisting conditions". My mom had hypertension but it was well under control and she was perfectly fine the day before and yet they are not honoring this clause as stated in their policy. Could you help us file the appeal?

1 Lawyer Answer
Tim Akpinar
Tim Akpinar
Answered
  • Insurance Claims Lawyer
  • Little Neck, NY

A: A Virginia attorney probably advise best, but you posted last week, and time is of the essence in the matter you describe (the appeal). Don't lose time awaiting an offer of legal services on this forum - the format here is brief Q & A. It isn't set up like a referral service for attorneys to offer their services to you. If you want to hire an attorney to handle the appeal, you're going to need to reach out to one. Some of your options include searching for an attorney on your own, using the "Find a Lawyer" tab above, or checking with local and state bar associations.

Check the fine print on the back of the denial or EOB. There may be forum selection clauses if you need to litigate or arbitrate the matter, depending on the health insurance carrier. If disputes are limited to courts of a certain state, or to be resolved applying the laws of a given state, learn that before reaching out to attorneys. Whatever the conditions, one thing is universal in those denials - there is usually a limited time window to appeal. I hope your mom is okay. Good luck

Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.

The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.

Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.