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When medical claims are denied, insurance defense kicks in

For many people in Kentucky, having reliable health care insurance is critical to their ability to finance unexpected costs associated with various trips to the doctor and treatments. Having insurance is important for people to stay protected in circumstances where unanticipated injuries or illnesses occur. However, there are times when people may be surprised to find out that their claim was denied by their provider. 

Insurance companies are very thorough in their process of creating and articulating their contracts. However, there are times when complicated situations can make it difficult for adjusters and customers to have a clear vision of who is responsible for footing the costs of a certain bill. When a claim is denied, an unsatisfied customer may plead their case and fight for compensation. In these situations, the insurance company may consider defending themselves. 

According to verywellhealth.com, there are some common reasons why people's insurance claims could be denied including the following;

  • Their coverage was terminated for one reason or another.
  • Their plan does not cover certain procedures or treatments.
  • Their personal information is incomplete or was never filed with their health care provider. 
  • Their time allowed for filing a claim has lapsed before they brought their concerns forward.

Healthcare.gov suggests that people take the time to thoroughly read through and understand their policy before making any notable decisions regarding their health care. People should also look for a physical card in the mail that will include their policy information and number. This information is helpful for them to take to all doctor's office visits. Upon receiving this card, people can be confident that their coverage is activated. 

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