INSURANCE FRAUD LAWYER
If you are sick or injured and need medical treatment, you typically have the option to select an out-of-network physician to provide care, with the knowledge that you will pay a higher percentage of the cost compared to an in-network provider.
Your health insurance provider, however, still must reimburse you for the percentage of the cost outlined in your policy. Failure or refusal can cost you a substantial amount through over-billed out-of-network charges.
Attorneys here at Quantum Legal LLC provide policyholders from across the country with a voice. We can protect your rights against fraudulent business practices, including excessive out-of-network medical billing. Our lawyers have spent more than 20 years using class action and other complex litigation to recover the compensation our clients deserve and expose fraudulent practices in the health insurance industry.
We Can Protect Your Legal Rights And Your Finances
Group health insurance plans require that patients pay a higher percentage of the cost of out-of-network care in order to deter policyholders from choosing more expensive medical care. These companies purposely understate how much some medical treatments and other procedures typically cost and leave policyholders to pay the difference.
Your insurance plan may cover 80 percent for a doctor’s office visit. However, the insurance company may calculate the charge for a visit at only $80 when the doctor charges $150, which means the company would only reimburse $64 of the charge. The insurance company, in effect, has only covered about 42 percent of the office visit. These discrepancies are large and put the onus on patients to pay for high medical bills that should have been covered.
Our lawyers do not believe that policyholders should have to pay extra due to intentional miscalculations by their insurance companies. This is a form of group health insurance fraud, and companies that engage in these activities should be held accountable for their fraudulent practices.