Insurance claims in West Virginia can be filed for numerous events, including car accidents, homeowner catastrophes and medical costs. You pay for insurance so that you’re covered in times of need, but what can you do when the insurance company underpays or denies your claim? If you’re not receiving all the money you’re entitled to from an insurance claim, you need to hire a lawyer to file a “bad faith” claim against your insurer.
Especially in the medical billing industry, the pricing for services, supplies and medications is completely non-regulated, which leads to gross underpayment of medical claims for many people. Particularly for what insurers deem as “Out of Network” services, claims can be grossly underpaid or even denied. According to a report published in June 2009 by a U.S. Senate Committee on Commerce, Science and Transportation, insurance companies base their payments for out-of-network claims on what they call the “usual, customary and reasonable” (UCR) charge for a service, rather than on a healthcare provider’s actual charge. As a result, patients end up footing a major portion of the bill, since UCR charges can be quite divergent from actual charges.
In the auto insurance industry, underpayment often occurs when drivers are forced to get an estimate for repairs by an inferior auto body shop that is often in the insurance company’s back pocket. In these cases, if the driver wants to get the work done at another body shop, he or she has to pay the difference in cost, even though the repair could not be adequately completed at the “recommended” body shop.
Trust your instincts. If you feel like an insurance company is cheating you, there is a chance that you are. Sadly, insurance companies often only have their bottom line in mind, not your best interests. Contact a West Virginia lawyer to discuss your case before you pay for costs your insurance company should be covering.