If you have carried a health insurance policy for several years and paid your premiums promptly, you may be shocked when the company refuses to pay for certain medical expenses. In some cases, you have the right to file a lawsuit against the insurance company in order to recover the expenses that the company should have paid. Taking legal action can be time consuming and expensive, especially if you are already dealing with high medical bills that have not been paid. Make sure you understand your rights before you begin legal proceedings.

Denial of a Legitimate Claim

You have the right to sue your health insurance company if they have refused to pay for a legitimate claim that qualifies under your specific policy. It can be difficult to know when to begin legal action, however, because the insurance company may not always refuse your claim outright. You can file a lawsuit if you feel that the insurance company is intentionally delaying the processing of your claim, or the compensation offered for your claim is far less than it should have been. Your insurance policy should have an explanation of how long you will normally wait for payment after filing a claim. If your claim process is taking far longer than the promised amount of time, legal action may be necessary.

Make Sure You Understand the Policy

Before you file a lawsuit, make sure that you fully understand every part of your health insurance policy. You may be surprised to find that some procedures that you thought were covered are not. Most insurance policies are very detailed about which types of service are covered and which types fall under special circumstances. You will save yourself quite a lot of time and money if you take the time to read your policy carefully before you begin any legal action.

Consult with an Attorney

If you are convinced that the insurance company has not acted in good faith, the next step before filing a lawsuit is to consult an experienced attorney. The attorney will consider your documentation and help you create a solid case against the insurance company so that your legal action has a better chance for success. The attorney will also advise you if your case does not qualify for legal action. In many cases the attorney may suggest that you go through an arbitration process with the insurance company instead of filing a lawsuit. Arbitration can help you recover any funds that are due to you without the expense or prolonged experience of a legal trial. There are attorneys who specialize specifically in health insurance cases and understand how to approach legal action against an insurance company.