Would you know what to do if your health insurance claim is denied?
MIAMI - Millions of Americans are weighing in with grievances about healthcare insurance after United HealthCare CEO Brian Thompson was brazenly shot and killed in Manhattan last week.
Since his death, people have taken to social media to express their frustrations, many sharing how denied insurance claims have affected their lives.
CBS News Miami sat down with Russell Lazega, an insurance claims attorney based in South Florida and asked him, what do you do when your claim is denied?
"You have to go through the insurance company's internal appeals process. What a lot of folks don't know is that when you do that, you're creating a record to any future case or challenge to that appeal decision," said Lazega.
Lazega adds, that it's critical to meticulously document every step of the process because if you fail to do that, it won't be considered later.
He says getting an attorney is your best bet, but he says it won't be easy.
"Very often if the insurance is through your work, you have to go through a very rigorous appeals process. It's a lot of legal work to put that together and there's no way to get paid — if the insurance company denies the appeal or you have to go to court. The only way you can get paid is through the client, who is already struggling," said Lazega.
Lazega says a majority of the time, he has to deny taking on clients because of this and says time is often of the essence.
"You got an insurance company fighting on the appeal and oftentimes trying to delay that, figuring it's cheaper to hire lawyers and fight you than to pay the doctors to save you," said Lazega.
Lazega adds insurance companies often will try to wear people out, so they'll go away.
He says the best thing you can do is to be vigilant with your documentation and to be persistent.
"You got to be your best advocate, if the insurance company is telling you no and your doctors are telling you yes, then do the work to advocate," said Lazega.
Some insurers are rejecting nearly one in five claims. That's according to a 2021 analysis by KFF, an independent source of health policy research, polling, and journalism.
Lazega says the earlier you start with documentation for your appeal if your claim is denied — the better.
