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Bad Faith Nevada

Discussion in 'Health Insurance, HMO, HIPAA & Disability' started by Ironrod, May 15, 2018.

  1. Ironrod

    Ironrod Law Topic Starter New Member

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    Jurisdiction:
    Nevada
    My health insurance has denied multiple claims for my wife. Her primary doctor and nuerologist has sent multiple claims for my wife to recieve treatments. The drug they want to use is covered under the plan.

    Their failure has lead to 7 hospitalizations. My wife now has permanent and temporary parlizations.

    Do I have a case for bad faith or medical malpractice? How should I proceed?
     
  2. ElleMD

    ElleMD Well-Known Member

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    No way to tell based on the little you shared. A insurance company can't commit malpractice but could breach the contract if they didn't ave a good reason for denying treatment and you followed the appropriate appeal claim process and appealed as defined in your plan documents. Did you? What reasons were given for the denials?
     
  3. mightymoose

    mightymoose Moderator

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    Your problem doesn't seem to be one of medical malpractice but one of insurance coverage. Review your insurance policy and speak to an attorney about the denied claims if you are certain you had coverage.
    What reason were you given for the multiple denials of the prescribed treatments?
     
  4. zddoodah

    zddoodah Well-Known Member

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    There's no conceivable way to evaluate potential insurance bad faith based on four sentences in a post on the internet (and, as noted in one of the prior responses, your post doesn't raise any issue of medical malpractice). You will need to take your policy documentation, along with all documentation relating to the denied claims, to an attorney who handles insurance bad faith claims.
     
  5. army judge

    army judge Super Moderator

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    If someone on your insurance policy suffered medical malpractice, you should speak with a medical malpractice attorney.

    If your issue is with your insurance company, read your policy.

    Most insurance policies, maybe all policies, limit an insured's ability to sue the insurer.

    If there is an issue of concern about the service or coverage, you'll probably be required to seek mediation or arbitration to resolve the matter.

    It can be helpful to talk with a local attorney, as most offer the first consultation free of charge.
     

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