How the Game Really Works (Why Insurers Stonewall Until the Last Possible Minute)

It's bad enough that you have gone to the doctor and found out that you've been diagnosed with a malady that requires treatment, and that renders you unable to perform your work functions. You already have enough to worry about, you have health insurance, and the last thing you want to worry about is your future financial security.

It always seems like a cruel twist of fate that now, when you already have so much to deal with, your future financial security is unknown. Why? Because the health insurance company is dragging their feet. You paid your health insurance premium each month so why are they stalling?

There are a variety of tricks that a health insurance company will use to delay paying as long as possible.

One of the first things an insurance company will do is demand that another doctor review your case. They will refuse to pay your medical bills until they have received a second opinion from a different doctor, normally one of their choosing. Insurance companies are even more inclined to do this if you are diagnosed with a condition that makes it impossible for you to earn a living. There are two reasons that insurance companies insist on this second opinion. The first reason is that they are hoping the second physician might diagnose something completely different. The second reason is that it gives the health insurance company time to carefully review your policy and see if there are any loopholes allowing them to continue to deny payment.

If your insurance company is stonewalling on a payment, don't continue to let the bills pile up. If the insurance company has not responded within thirty days, get on the phone and start demanding explanations. Be politely persistent. Work your way up the health insurance company's corporate ladder until you are able to talk to someone who actually has knowledge of your policy. Keep a written record of the names of the people you have spoken to and write down key pieces of information.

If a phone call is not getting results, start soliciting support. See if your doctor is willing to talk to the insurance company. If it really doesn't look like the insurance company is going to provide compensation, it’s definitely time to consider talking to a lawyer.

In the event that your insurance claim is denied, do not hesitate to contact David Share Associates, a leading long term disability insurance and personal injury law firm in Toronto, Ontario, Canada.