Albuquerque Medical Insurance Bad Faith Lawyers

At Collins & Collins, P.C., we are dedicated to fighting for individuals and families harmed by medical insurance bad faith. Medical insurance companies are obligated to provide coverage for necessary medical treatments, but too often, they wrongfully deny or delay claims, putting profits over people. These practices are particularly dangerous when they result in delayed or denied medical care, leading to severe health consequences, financial devastation, or even death.

Medical insurance bad faith is a key focus of our litigation efforts because we believe no one should suffer due to an insurance company’s refusal to honor its obligations. When these companies engage in bad faith practices, they often target people when they are most vulnerable—facing serious health crises and needing immediate care. Collins & Collins, P.C. holds these insurers accountable, ensuring that individuals receive the care and compensation they deserve.

What Is Medical Insurance Bad Faith?

Medical insurance bad faith occurs when an insurance company unjustly denies, delays, or underpays claims for medical treatments that should be covered under the policy. Common bad faith practices in the medical insurance industry include:

Unjustified Denial of Claims:

Insurance companies frequently deny claims for treatments or medications by claiming they are “not medically necessary” or “experimental” when they are clearly needed and recommended by medical professionals.

Unreasonable Delays in Approving Treatment:

Insurance companies may drag their feet in authorizing treatments, tests, or surgeries, leaving patients to suffer while their conditions worsen.

Refusal to Pay for Life-Saving Care:

In some cases, insurers may outright refuse to cover critical treatments, such as surgeries, cancer therapies, or emergency procedures, even when those treatments are vital to the patient’s survival.

Manipulation of Policy Terms:

Insurers may misinterpret or misrepresent policy language to avoid paying for care. They often claim that a treatment falls under an exclusion or isn’t covered, even when the policyholder has a clear entitlement to the benefit.

The Impact of Medical Insurance Bad Faith: Life or Death Consequences

When medical insurers deny or delay necessary care, the stakes couldn’t be higher. These wrongful actions can have catastrophic consequences for patients and their families:

• Delayed or Denied Care: For patients battling serious illnesses like cancer, heart disease, or chronic conditions, timely treatment is critical. When insurers delay approvals or deny coverage outright, patients may be forced to delay or forgo care, which can lead to worsening health, long-term disability, or death.
• Financial Hardship: Medical bills are often exorbitant, and a wrongful denial of coverage can leave patients and their families buried in debt. Even when treatment is eventually approved after an appeal, patients may already be dealing with the financial consequences of paying out-of-pocket for necessary care.
• Emotional and Mental Distress: The stress of dealing with a serious illness is compounded when patients are forced to fight their insurance company for coverage. The emotional toll of navigating the appeals process, dealing with mounting medical bills, and facing potential health consequences is immense.

Examples of Medical Insurance Bad Faith

There are many ways in which medical insurers engage in bad faith practices. Some of the most common examples include:

• Denial of Coverage for Pre-Existing Conditions: Despite protections under the Affordable Care Act (ACA), some insurers still try to deny coverage by arguing that a condition is pre-existing or not covered under the policy.
• Unjustified “Experimental” Labeling: Insurers often deny claims for treatments, therapies, or medications by labeling them “experimental” or “investigational,” even when they are widely accepted by the medical community as standard care.
• Failure to Pay for Emergency Care: Even in clear emergency situations, some insurers refuse to cover hospital visits, surgeries, or followup care, claiming that the situation wasn’t “urgent” enough under their terms.
• Denied Mental Health Treatment: Insurers frequently deny coverage for mental health care or substance abuse treatment, despite the clear medical need for these services, especially in the case of crisis interventions.

Why Medical Insurance Bad Faith Is a Key Focus for Collins & Collins, P.C.?

Collins & Collins, P.C. is particularly committed to fighting medical insurance bad faith because of the life-or-death consequences that often accompany these cases. When an insurer denies coverage for a life-saving surgery, delays cancer treatment, or refuses to approve necessary medication, it is not just about financial loss—people’s lives are on the line. We take these cases seriously, and our team works tirelessly to hold insurers accountable for their reckless behavior.

Our firm has a deep understanding of how medical insurers operate, and we know how to counter their tactics. We fight to make sure that insurers live up to their obligations and pay for the care that patients need to survive. We are especially driven when the person affected is a child. No child should have to go without treatment because an insurance company is trying to cut corners and avoid paying a claim. In these cases, we aggressively pursue justice to ensure that insurers cannot escape responsibility when lives are at stake.

How Collins & Collins, P.C. Fights Medical Insurance Bad Faith

At Collins & Collins, P.C., we know how to take on big medical insurance companies and win. Here’s how we handle medical insurance bad faith claims:

1. Thorough Case Investigation: We conduct a comprehensive investigation of the denial, gathering medical records, policy documents, and expert opinions to build a strong case that proves the insurance company acted in bad faith.
2. Aggressive Litigation: If necessary, we aren’t afraid to take insurance companies to court. Our team of experienced trial attorneys knows how to present compelling evidence and force insurers to pay what is owed.
3. Maximizing Compensation: Our goal is not only to recover the benefits our clients were wrongfully denied but also to seek damages for any financial and emotional harm caused by the insurer’s misconduct.