Lately, I’ve been contacted by several claimants with recently denied claims asking for my help. I know I’ve written about this before, mainly to encourage claimants and insureds to contact me BEFORE claims are denied and not AFTER. Most of my readers may remember that I am always writing about, “The best way to be successful with an appeal is to avoid one in the first place.”
The value of having an expert Consultant on board to assist you with the management of your claim lies in the expert’s advice, contractual or Plan knowledge, and complete understanding of the claims process. Most legitimate claims shouldn’t be denied if they are managed well.
I object to attorneys who tell insureds, “Oh, your insurance company will deny your claim”, or, “there’s nothing you can do, your insurer will likely deny your claim – come back when they do.” Sorry attorneys, this just isn’t true.
While we can never predict or anticipate what insurers will do, Consultants can always make sure claims are well managed in the best interests of their clients. There is a value in having help from those who have actual claims experience.
Therefore, the time to contact a claims manager is when the claim is still paid, not when the claim has already been denied. Once a claim is denied the only option is an attorney. Attempting to send in an appeal on your own is very unwise.
While I regret not being able to assist with appeals, I can say that the best value obtained by having a Consultant on board is having expert knowledge about the claims process at your finger tips.
If you know what the insurance company is going to do, then a Consultant will know what to do about it, and how best to present the claim with points of view favorable to you.
Waiting for a denial is never your best option.