Can I Sue An Insurance Company Or Hmo When It Has Refused To Pay For Treatment?
Free Insurance Quote Comparison
Secured with SHA-256 Encryption
UPDATED: Jul 16, 2021
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes and legal advice should be easy. This doesn’t influence our content. Our opinions are our own.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
ERISA provides that group health plans have 90 days to respond to presented claims. Employees have 60 days to appeal a denied claim. Within 60 days of the notice of appeal, the plan must respond with a written explanation of the reason for denial. This procedure is to be followed in order to exhaust administrative remedies prior to initiation of litigation. There are proposed Department of Labor regulations that provide for a much faster process in the event of denial of an urgent care claims.