Critical illness insurance is an insurance product where the insurer is contracted to pay money (lump sum or structured) if the policyholder is diagnosed with one of the critical illnesses listed in the insurance policy.
These are ‘peace of mind’ contracts. The contract or policy will set out several definitions and terms. Contractual definitions and terms are almost always open to interpretation.
Most of these denials involve disputes over definitions of when a diagnosis of a critical illness is considered valid, allegations of misrepresentation, non-payment of premiums, and exclusion clauses.
Our insurance denial lawyers have successfully resolved denied critical illness claims by bringing forth the medical and collateral evidence required to resolve disputes over critical illness coverage.
Even in circumstances where the insurance company permits you to appeal the decision, it is still important to seek legal advice from a, insurance denial lawyer for the following reason:
YOU ONLY HAVE A LIMITED TIME WITHIN WHICH TO TAKE LEGAL ACTION. THIS IS CALLED A LIMITATION PERIOD. WHEN THE TIME LIMIT BEGINS TO RUN WILL DEPEND ON THE FACTS OF YOUR CASE.
Time limits are not the same for every policy and every circumstance and that is why it is essential to get legal advice to know what time limits apply in your particular circumstance.
If an insurer has wrongfully denied you benefits, you may have no alternative but to take legal action.