Critical Illness Insurance Lawyers

Critical illness insurance policies are often purchased by individuals through licensed insurance agents or brokers. Some employer group benefit plans also contain this type of coverage, but the issue of misrepresentation most frequently occurs with an individual policy.

During the application process to purchase coverage, clients must typically complete an extensive medical questionnaire. Insurance companies regularly review the answers provided on this application to see if they can deny a claim based on false or inaccurate information.

If you believe that there was no error or omission regarding the information you provided, it may be possible to challenge the insurance company’s denial. Contact one of our critical illness insurance lawyers to discuss your chances of success in pursuing the claim further.

If you bought this type of insurance, you were likely told that you would be paid out the value of your policy if you were diagnosed with one of the critical illnesses it covers. And yet, if you have been diagnosed with one of those covered illnesses, your claim may still be denied.

Sometimes, the denial is based on a policyholder not contracting a severe enough form of the illness, as defined in the fine print of your policy. Your claim might also be denied because, while your illness appears to fall under one of the listed categories, the insurance company takes the position that it doesn’t fit squarely within the defined wording. With contract phrasing being so open to interpretation, a critical illness insurance lawyer is a powerful ally to have.

Below is a typical list of covered illnesses*:

• Cancer

• Heart attack

• Stroke

• Blindness

• Alzheimer’s

• Multiple Sclerosis (MS)

• Organ Transplants

• Kidney Failure

• Paralysis

• Motor Neuron Disease

(*this list is only an example of covered illnesses and the list for your particular policy may differ, so always check the policy wording carefully).

Contact one of our critical illness insurance lawyers to discuss your chances of success in pursuing the claim further.

Here is an example of how a critical illness insurance claim may be denied. A 55-year-old man has critical illness insurance that provides coverage for a payout in the event he suffers a heart attack. While there was little doubt that he suffered a heart attack, the policy wording requires new electrocardiogram (ECG) changes consistent with a heart attack. The claim was denied because the insurance company determined that the degree of ECG changes was insufficient to warrant a payout of the policy.

When discussing this with his doctors, they believed that he should be entitled to the payout. What can he do to fight this?

This type of situation is one that the critical illness insurance lawyers at Share Lawyers would review to evaluate the chance of success in pursuing the claim. We do this by conducting a thorough review of the medical information the insurance company reviewed, plus any additional medical records that may have been overlooked, and consult experts to determine whether the insurance company’s interpretation of the policy wording was too strict.

Contact one of our critical illness insurance lawyers to discuss your chances of success in pursuing the claim further.