Critical Illness Insurance in Oklahoma and How to Overcome a Claim Denial

Oklahoma residents carry health insurance to help reduce out-of-pocket costs of healthcare. This is important for a serious illness that can overwhelm your budget.

Even if you have health insurance, treatment for a critical illness can be hard to pay for. For example, if you have bronze insurance coverage with a cancer diagnosis, you can be out thousands of dollars. Your costs can include diagnosis, treatment, and rehabilitation. Your insurance may only cover 60 percent of your medical bills for:

Imaging Tests
Radiation Treatment
Prescription Medication
Hospital Costs
Surgery
Specialist Referrals
Home Care

About two-thirds of Americans live paycheck to paycheck. For them, paying for critical illness treatment can be hard or impossible. This is why critical illness insurance exists. It covers unexpected serious illnesses or acute medical conditions. In this way it can help to avoid bankruptcy.

But trouble can come if the insurer denies your claim. This happens more than it should.

At the Aizenman Law Group, our Tulsa insurance claim attorneys help people overcome critical illness insurance coverage denials. If your critical illness insurer denies your claim, then call us at 918-215-8856. You can reach us at any time, on any day including holidays.

What is Critical Illness Insurance?

Critical illnesses or medical conditions can happen suddenly. They can include a heart attack, a stroke, Parkinson’s disease, or an organ failure needing major surgery. Critical illness insurance softens the financial blow to you from such an unexpected event.

Critical illness insurance is supplemental insurance. It does not replace your policy of health insurance. This insurance provides you with a lump sum on payout. You can buy critical illness insurance as a standalone policy from an Oklahoma health insurer. Or you can include it as an add-on rider through your employer’s health benefits. You can also add it to a policy of life insurance.

You can use critical illness insurance benefits for any purpose. They are not restricted to paying medical costs.

If a critical illness causes death, critical illness insurance can pay benefits to that person’s family. This can help them cope with the consequences of the sudden loss of a loved one.

Who Provides Critical Illness Insurance in Oklahoma?

The following list is of insurance providers offering individual supplemental insurance that includes critical illness insurance. It may not include all insurers that offer supplemental insurance in Oklahoma.

Why Do Critical Illness Insurance Claims Get Denied?

Critical illness insurance policies often have specific conditions that limit or exclude coverage. For example, your policy might have a waiting period before you’re eligible to receive benefits, or it may set maximum benefit amounts depending on the type of illness. Some policies also exclude certain illnesses entirely.

Examples of conditions that critical illness insurance may not pay benefits for include:

Pre-existing chronic conditions like diabetes or asthma
Illnesses or injuries caused by illegal behaviors or substance abuse
Self-inflicted injuries

There are two common reasons why your critical illness insurer might reject your policy claim: your policy excludes the illness, condition, or injury you are making a claim for, or the condition is not serious enough to meet the insurer’s definition of being critical.

Examples of these two reasons include:

Self-inflicted harm
Failing to seek appropriate treatment
Failing to adhere to your treatment plan
An illness or condition from lifestyle choices like smoking or substance abuse.

The insurer concludes that you have not given it enough information about the claimed illness or injury:

For example, it might decide your condition is a pre-existing one.

The insurance company relies on a technical issue to deny coverage:

This can be a failure to keep up with policy premium payments.
Or your claimed illness occurred outside your policy’s age limit for that kind of condition.

What Can You Do if Your Critical Illness Insurer Denies Your Claim?

Oklahoma critical illness insurance companies can wrongfully deny benefit claims. If this happens to you, the Aizenman Law Group can help you overcome a wrongful claim denial.

How our claim denial attorneys helped clients receive favorable settlements after wrongful denials.

Example One: Overcoming an Incorrect Assumption of the Cause of the Condition

Our client made a critical illness benefits claim for a brain bleeding condition. This condition was nontraumatic subarachnoid hemorrhaging. Despite her doctor’s medical diagnosis, the insurance company denied her claim. It claimed the bleeding was from a traumatic event.

An Aizenman Law Group traumatic brain injury attorney showed the insurer lacked evidence to prove its argument. The insurer backed down. Our client then received a favorable settlement of her critical illness insurance claim.

Example Two: Overcoming an Insurer’s Incorrect Pre-Existing Condition Denial

Our client received a diagnosis that a lump in his throat was cancerous. He made a claim under his critical illness insurance policy. The insurance company said he knew or should have known that this was a pre-existing condition.

An Aizenman Law Group claim denial attorney showed the insurer wrongly applied the pre-existing condition exclusion to our client. The insurance company had no evidence to back up its pre-existing condition argument. This led the insurer to reassess its denial. Our client later received a favorable settlement of his critical illness claim.

Having the Right Wrongful Claim Denial Insurance Law Firm Makes a Difference

In each case above the Oklahoma insurance company reflexively denied our clients’ legitimate critical illness claims. It did so even though it had no evidence to support its denial decision.

In the first case it took an Aizenman Law Group traumatic brain injury lawyer to make the insurer reconsider its hasty decision about how brain bleeding began.
In the second case an Aizenman wrongful denial lawyer reversed the insurer’s wrongful denial, putting the burden of proof back on the insurer.

The Tulsa wrongful claim denial lawyers at the Aizenman Law Group have the experience and expertise to help you with any kind of critical illness insurance policy coverage denial.

Just because the insurance company denies your claim does not mean that the insurance company is right to do so. Don’t resign yourself to losing the critical illness benefits you deserve without talking with an Aizenman Law Group insurance claims lawyer first.

You owe us nothing if we cannot favorably settle your claim.