Health Insurance Company Denied Your Claim??

[Jason Freeland]

My wife used to do CDI work. She enjoyed it.

Yep, it's essentially medical voyeurism. You read all about what is ailing the person and have access to the whole chart. Have to keep privacy in the front of your mind at all times.

 

[Frank Pope]

I cannot vouch to the effectiveness but I figure given Grumpy's recent adventure I might get the chance to try it out.

Your first move here should be to file a deceptive claims practices complaint with the Insurance Commission., Don't get me wrong, the Commission will do nothing with it, but if the company is even a little sensitive to PR (some have no reputation and don't care), they will not want this pending and may cause them to take a second look.

 

[Lightsluvr]

It is my professional experience (50 years in insurance claims) that the insurance commissioner's customer complaint and fraud units are very pro-active. There are specific timelines in Oklahoma Statute 36 that govern good faith claim handling in Oklahoma. One prohibited act under the statute is a failure to investigate a claim before denying or taking other adverse action. I would comment that some of the largest punitive damage awards in Oklahoma were against health insurance carriers. Just sayin'.

 

[XYZ]

@Lightsluvr good info.
Thanks for sharing.