Oakland Long Term Care Attorneys

Oakland Long Term Care Attorneys

Having a long-term care claim denied can be a distressing experience, often leaving individuals and their families feeling overwhelmed and uncertain about their next steps. Understanding the reasons behind a denial is crucial, as it can stem from various factors. Navigating the complexities of claims and denials requires careful attention and professional assistance to ensure that one’s rights are protected and that a fair resolution can be achieved. At Monahan Tucker Law, our Oakland long-term care attorneys are passionate about helping clients receive the benefits they deserve and holding insurance companies accountable for their actions.

Common Reasons for Long Term Care Claim Denials

There are many reasons why a long-term care claim may be denied, and it is essential to understand these potential roadblocks. Some of the most common reasons for denials include:

• Incomplete or incorrect information on the application: Insurance companies can use any discrepancies or omissions on an application as grounds for denial.
• Pre-existing conditions: If an individual has a pre-existing condition that was not disclosed in their application, the insurance company may deny their claim.
• Failure to meet policy requirements: Long-term care policies have specific requirements that must be met before benefits are paid out. This could include needing assistance with daily activities or being unable to perform certain tasks without assistance.
• Lack of medical necessity: Insurance companies may deny a claim if they do not believe the individual meets their definition of “medically necessary” for long-term care.
• Non-payment of premiums: If an individual has missed premium payments, their policy may be canceled, and any claims will be denied.

Navigating the Appeals Process

If an individual’s long-term care claim is denied, it does not necessarily mean that they are ineligible for benefits. In many cases, a denial can be appealed with the help of an experienced attorney. The appeals process may involve providing additional evidence or documentation to support the claim or challenging the insurance company’s decision through legal means.

At Monahan Tucker Law, our Oakland long-term care attorneys have extensive experience with the appeals process and fighting for our client’s rights. We understand the emotional toll that a denied claim can take, and we are committed to providing compassionate and professional representation to help individuals and their families receive the benefits they need.

Taking Legal Action

In some cases, an insurance company’s denial may be due to bad faith practices or a violation of state laws. If this is suspected, it may be necessary to take legal action against the insurance company. This could involve filing a lawsuit seeking damages for the individual’s losses and holding the insurance company accountable for their actions.

At Monahan Tucker Law, we have a team of skilled litigators who are prepared to take on insurance companies and fight for our clients’ rights. Our Oakland long-term care attorneys have a deep understanding of insurance laws and regulations, and we are dedicated to obtaining the best possible outcome for our clients.

Contact Us

Navigating a long-term care dispute can be overwhelming and stressful. Monahan Tucker Law is here to alleviate that burden by providing effective legal guidance and representation. Contact us today to schedule your initial consultation.