I know that insurance companies can be difficult to deal with; if a member of your family held health insurance, than why can't it be used? Insurance claims are not always straightforward, which can make matters even harder. Here are a few reasons why your deceased family member's claim was rejected and what steps you can follow.
Possible Explanations Regarding Your Deceased Family Member's Claim Denial
Here are some of the most frequent reasons on why a claim was denied:
"Subrogation" is What You May Be Looking for
A great majority of health insurance providers hold what is referred as a "subrogation" clause. Basically what this means is if there was someone who was injured from an accident or wreck and there was a separate form of insurance that could cover those medical bills, then those other insurance plans should be used instead.
For instance, if there was a pedestrian that was impacted by a vehicle and that pedestrian injured their leg, then the insurance of the driver that hit the pedestrian would be technically open to paying the injured pedestrian's medical expenses. Because of the subrogation clause, the injured pedestrian must file a claim against the at-fault driver's insurance police instead of their own health insurance coverage.
Why Does Subrogation Involve My Deceased Family Member?
In certain cases where the injuries of a patient were so serious that they died because of the wreck, subrogation can still be possible to occur. In essence, what this means is your deceased family member's health insurance company could reject paying for their medical bills because there is another type of insurance available.
For the deceased's family members (including you), this can mean that in order for the deceased's medical expenses to be covered, you would need to submit a wrongful death claim towards the at-fault person's insurance company.
By this point, I would strongly advise you to contact a wrongful death attorney (personal injury attorney) who could assist you in sorting through the insurance claims process and make sure you receive any compensation available on behalf of your deceased family member.
Submitting a Texas Wrongful Death Claim
Here in Texas, the family of the deceased family member has a right to pursue compensation available for medical bills, financial expenses, pain and suffering, and many other forms of compensation. It is common for the family members of the deceased to be left handling accident-related expenses, emergency services, and similar services that have high costs. Personal injury lawyers are specifically specialized in representing the deceased's family against the at-fault party's insurance company and fighting for their rights. Additionally, the legal terms and phrases that insurance companies use may be used to trick or confuse victims by having their claims denied or by offering a ridiculously low settlement offer. At the Anderson Law Firm, the attorneys not only hold a great amount of experience in combating insurance companies - we hold the highest reputation for representing and fighting for the rights of our clients.