Personal Injury Care Line

Pet Insurance & Public Liability Are You Safe From A Personal Injury Compensation Claim?

Are you one of the million of Britons famous the world over for being a pet owner and lover? If so, do you have pet insurance? If not, you may well want to read on if you want to save yourself millions of pounds.

Lets look at two, not uncommon, scenarios that may happen to a pet owner in the UK:

Scenario 1:

You own a dog. The dog is out in the garden. The post comes to the house to deliver a letter. In the course of delivering the letter your dog bites the postman.

Scenario 2:

You own a horse. The horse is grazing in the field. The horse is startled, jumps the hedge and crashes into an oncoming car.

Do you know what would happen in both of these scenarios? Well, if you dont already know, as you may recall from the recent famous case involving Princess Anne, in Scenario 1 you could be liable to pay damages under the Dangerous Dogs Act. Less well known, in Scenario 2 you could be liable to pay damages under a recent House of Lords interpretation to the Animal Act 1971. Either way, youre paying.

How can you limit the liability youll suffer if either of these unfortunate events where to occur? Without some form of pet insurance policy you could not. As such, if you have a pet and want to save yourself from the prospect of having to pay out a potentially large amount of money in compensation damages to a third party now is the time that you should be considering getting pet insurance.

Although pet insurance is unlikely to cover you for the full costs you that you may need to pay to both defend your self against a claim and also pay compensation if you lose, as there is likely to be a minimum excess payment and maximum cap payment, for a reasonable annual premium payment you can arrange to have cover that would pay a large portion of this amount.

At the end of the day, however, having pet insurance is like having any other type if insurance. Would you go out n the roads and drive your car without insuring yourself against an accident? Would you leave all your valuables at home without having any home contents insurance? Do you want to take the chance that you could be used for million in personal injury compensation without having paid a minimal amount in pet insurance?

Nowadays auto insurance is the ideal way to ensure a good life for yourself and your expensive vehicle. Auto insurance keeps safe your huge amount of money spent on your automobile. But on the same hand, auto insurance is also quite expensive. However there are different types of auto insurance policies available today. It is at an individuals discretion which policy he can afford to adopt.

1.Fully Comprehensive Auto Insurance Policy Types- though this policy is the most expensive one yet it is the most widely adopted type of auto insurance. This is so because the insurance provides compensation or covers all sorts of cases such as theft, accident, wear and tear etc. If unfortunately an accident occurs where you were not at fault while the other driver who did the accident does not disclose his and his insurance details; you ought not to worry. For being a policyholder of the fully comprehensive program, you can register an insurance claim against your insurance company. But while taking this policy one essential thing should be borne in mind. There are a few auto insurance companies that do not insure your vehicle 100% of its value but of 80% or so. Even though many companies defend their policy as a measure to prevent themselves from fraud cases etc. yet try your bets to find the agency that insures your vehicle 100%.

2.Third Party, Fire and Theft- this type of insurance is basically meant for those car owners who have had finished their car loans but still admire, cherish their car and have great sentiments attached to it. This policy is somewhat akin to the fully comprehensive one but not identical to it. For like the latter the former covers cases of theft, accident, fire etc. but in case of an accident you can receive compensation only when you were at fault and had hit another car. So if any other car hits yours or you by mistake bang t in the garage, the insurance company will not come to your financial aid.

3.Third Party Insurance- it is the insurance that is the cheapest of all and covers only cases of accident where you were at fault and hit a third party. The insurance company is not to be contacted in case of any other mishappening with your vehicle. This insurance policy is generally preferred by those who own an old and less pricey car or any other vehicle.

4.Specialized Car Insurance- is basically for cars categorized as classic, those that are 25 years old. These cars are insured as classic and so accordingly they have their requirements and services. The classic car insurane policy can be said to be as good as the comprehensive one but the only drawback associated with it is that it limits the policy taker to a limited number of road miles he can drive in any given year.

Ultimately it is at the discretion of every individual which policy he desires to take. It is advisable to sort out ones requirements and budget and also make a survey of the auto insurance policies in the market before actually grabbing a policy.

Battling an Unfair Health Insurance Claim Can Really Pay Off

Are you having trouble getting your insurance company to pay your medical health costs? Join the club. When managed care entered the insurance scene a decade ago, its mandate was to contain rising medical costs. One way to do that is to deny claims, even when claims are legitimate. The consumer backlash led to many states establishing independent review panels and requiring insurance companies to develop in-house appeal procedures. Forty-two states now have independent review boards whose decisions can override those of insurance companies. Most consumers don’t even realize these review boards exist.

Another problem is that too many people just give up when their insurance claim is denied initially. The appeals process can be long and frustrating and many people don’t have the patience or time to pursue a claim no matter how legitimate. People must be persistent and they can win. Particularly if there’s substantial money involved, the time you dedicate to appealing insurance company decisions can pay off usually more quickly than you think. A Kaiser Family Foundation study recently found that 52% of patients won their first appeal for each claim made. The insurance companies aren’t getting with out paying anymore.

If your first appeal gets turned down, press on. The study found that those who appealed a second time won 44% of the time. Those who appealed a third time won in 45% of cases. Which means the odds are in your favor no matter how long it take. Remember that every time you appeal it costs the insurance company more money to fight you and they are not only going to lose money to you, but also in court costs. Medical health benefits are particularly tricky because insurance companies usually have a cap on the amount of money they’ll spend in a given year, or on the amount of visits they’ll pay for. But there’s often some flexibility when you can document that you or your child’s health warrants more care than your policy usually covers. Here’s how to get started:

Do Your Homework

Read your Policy: What are the benefits? Which kinds of services are included? Outpatient or inpatient care? Is it a serious or “non-serious” diagnosis?

Know the law: Contact your local Health Association to determine your states legal requirements regarding insurance payments for all illness. Does your state require full or partial parity? Are parity benefits available only to patients with “Serious Illness” or is a so-called non-serious illness also included?

Provide written documentation: Some insurance companies may not consider some diagnosis’s serious. In this case, you will need documentation to validate required services. Obtain a letter of medical necessity from your doctor and get test results showing the medical need for you or your child to receive certain services, based on the diagnosis.

Keep good records: Remember, you’ll be dealing with a bureaucracy. Keep the names and numbers of everyone with whom you speak, the dates on which you spoke, and what transpired in the conversation.

Start early: If you can, start the appeals process prior to initiating treatment. If the doctor says your child will need to be seen once a week for a year, begin immediately to appeal your insurance company’s policy of reimbursing only 20 visits a year.

Call and Ask the Insurance Company:

What are the prerequisites for receiving health benefits?

How many visits are allowed annually for you or your child’s diagnosis? Can multiple services be combined on one day and be counted as only one day or one visit?

Which services must be pre-certified–by whom?

Be positive, polite and patient with the customer service representative. Remember that he/she is only the messenger, not the decision-maker. They are the gatekeepers and can either provide you with access to a decision maker or make your life miserable, depending on how you interact with them.

Be persistent. There are no magic bullets. Be like a dog with a bone and don’t give up until you get the answer you want. If you get nowhere after several calls, ask for a supervisor or a nurse in the pre-certification department.

Remember that you do have the right to appeal if your claim is denied. Most consumers get discouraged and will not continue to pursue a claim that should or could be paid. Insurance companies count on that happening, so get out there and claim what’s justifiably belong to you.

Pet Insurance & Public Liability Are You Safe From A Personal Injury Compensation Claim?

Are you one of the million of Britons famous the world over for being a pet owner and lover? If so, do you have pet insurance? If not, you may well want to read on if you want to save yourself millions of pounds.

Lets look at two, not uncommon, scenarios that may happen to a pet owner in the UK:

Scenario 1:

You own a dog. The dog is out in the garden. The post comes to the house to deliver a letter. In the course of delivering the letter your dog bites the postman.

Scenario 2:

You own a horse. The horse is grazing in the field. The horse is startled, jumps the hedge and crashes into an oncoming car.

Do you know what would happen in both of these scenarios? Well, if you dont already know, as you may recall from the recent famous case involving Princess Anne, in Scenario 1 you could be liable to pay damages under the Dangerous Dogs Act. Less well known, in Scenario 2 you could be liable to pay damages under a recent House of Lords interpretation to the Animal Act 1971. Either way, youre paying.

How can you limit the liability youll suffer if either of these unfortunate events where to occur? Without some form of pet insurance policy you could not. As such, if you have a pet and want to save yourself from the prospect of having to pay out a potentially large amount of money in compensation damages to a third party now is the time that you should be considering getting pet insurance.

Although pet insurance is unlikely to cover you for the full costs you that you may need to pay to both defend your self against a claim and also pay compensation if you lose, as there is likely to be a minimum excess payment and maximum cap payment, for a reasonable annual premium payment you can arrange to have cover that would pay a large portion of this amount.

At the end of the day, however, having pet insurance is like having any other type if insurance. Would you go out n the roads and drive your car without insuring yourself against an accident? Would you leave all your valuables at home without having any home contents insurance? Do you want to take the chance that you could be used for million in personal injury compensation without having paid a minimal amount in pet insurance?

Pet Insurance & Public Liability Are You Safe From A Personal Injury Compensation Claim?

Are you one of the million of Britons famous the world over for being a pet owner and lover? If so, do you have pet insurance? If not, you may well want to read on if you want to save yourself millions of pounds.

Lets look at two, not uncommon, scenarios that may happen to a pet owner in the UK:

Scenario 1:

You own a dog. The dog is out in the garden. The post comes to the house to deliver a letter. In the course of delivering the letter your dog bites the postman.

Scenario 2:

You own a horse. The horse is grazing in the field. The horse is startled, jumps the hedge and crashes into an oncoming car.

Do you know what would happen in both of these scenarios? Well, if you dont already know, as you may recall from the recent famous case involving Princess Anne, in Scenario 1 you could be liable to pay damages under the Dangerous Dogs Act. Less well known, in Scenario 2 you could be liable to pay damages under a recent House of Lords interpretation to the Animal Act 1971. Either way, youre paying.

How can you limit the liability youll suffer if either of these unfortunate events where to occur? Without some form of pet insurance policy you could not. As such, if you have a pet and want to save yourself from the prospect of having to pay out a potentially large amount of money in compensation damages to a third party now is the time that you should be considering getting pet insurance.

Although pet insurance is unlikely to cover you for the full costs you that you may need to pay to both defend your self against a claim and also pay compensation if you lose, as there is likely to be a minimum excess payment and maximum cap payment, for a reasonable annual premium payment you can arrange to have cover that would pay a large portion of this amount.

At the end of the day, however, having pet insurance is like having any other type if insurance. Would you go out n the roads and drive your car without insuring yourself against an accident? Would you leave all your valuables at home without having any home contents insurance? Do you want to take the chance that you could be used for million in personal injury compensation without having paid a minimal amount in pet insurance?

Pet Insurance & Public Liability Are You Safe From A Personal Injury Compensation Claim?

Are you one of the million of Britons famous the world over for being a pet owner and lover? If so, do you have pet insurance? If not, you may well want to read on if you want to save yourself millions of pounds.

Lets look at two, not uncommon, scenarios that may happen to a pet owner in the UK:

Scenario 1:

You own a dog. The dog is out in the garden. The post comes to the house to deliver a letter. In the course of delivering the letter your dog bites the postman.

Scenario 2:

You own a horse. The horse is grazing in the field. The horse is startled, jumps the hedge and crashes into an oncoming car.

Do you know what would happen in both of these scenarios? Well, if you dont already know, as you may recall from the recent famous case involving Princess Anne, in Scenario 1 you could be liable to pay damages under the Dangerous Dogs Act. Less well known, in Scenario 2 you could be liable to pay damages under a recent House of Lords interpretation to the Animal Act 1971. Either way, youre paying.

How can you limit the liability youll suffer if either of these unfortunate events where to occur? Without some form of pet insurance policy you could not. As such, if you have a pet and want to save yourself from the prospect of having to pay out a potentially large amount of money in compensation damages to a third party now is the time that you should be considering getting pet insurance.

Although pet insurance is unlikely to cover you for the full costs you that you may need to pay to both defend your self against a claim and also pay compensation if you lose, as there is likely to be a minimum excess payment and maximum cap payment, for a reasonable annual premium payment you can arrange to have cover that would pay a large portion of this amount.

At the end of the day, however, having pet insurance is like having any other type if insurance. Would you go out n the roads and drive your car without insuring yourself against an accident? Would you leave all your valuables at home without having any home contents insurance? Do you want to take the chance that you could be used for million in personal injury compensation without having paid a minimal amount in pet insurance?

About 50 years ago, health insurance started to be an attractive incentive offered by employers to attract and keep good employees. Overall, group plans tended to be inexpensive for employers, with employees contributing a small amount of money or none at all to secure health insurance for themselves and their families.

It was more expensive for individuals to pay for non-group policies, but coverage was fairly affordable. Then medical costs started to rise, people started to live longer and the medical profession became adept at curing various diseases and saving and prolonging the lives of people with serious injuries and life-threatening illnesses. Health care and insurance prices started rising much more quickly than annual incomes and premiums began taxing both employers, who were paying the lions share of premiums, and for employees, to whom businesses often passed on costs through larger deductibles, greater out of pocket expenses and higher premiums.

According to a recent report by the MSNBC News Service, 41 percent of Americans whose income ranges from moderate to middle had no health insurance for at least part of 2005. In 2001, that number was much lower28 percent. Additionally, more than 50 percent of uninsured Americans in 2005 found it difficult to pay their medical bills. Another alarming statistic28 percent of Americans in 2005 had no health insurance, while 24 percent had none in 2001.

So, what should a person do if they dont have any health insurance or if they have a choice between a cheap discount plan that does not cover core expenses and an affordable plan that may cost a bit more but also provides much better coverage? According to data from the U.S. Centers for Disease Control and Prevention, the majority of people who are not covered for important screening tests, such as a mammogram, colon cancer screening or a PSA test, will not undergo those exams. Also, close to 60 percent of people without health insurance missed treatment or did not buy medicine needed for a chronic condition.

All of these figures point to one thingpeople who lack health coverage for essential services are often unable to pay for those services, putting them at greater risk for developing new or exacerbating existent health conditions.

What should you look for in a health insurance plan, especially when cost is an issue? Its important that you get the best coverage you can afford. Skimping on premiums can save you money upfront, but the result can prove to be penny-wise and pound-foolish. Sometimes people cant afford coverage and sometimes they believe because they are healthy that they simply dont need it. However, healthy people get ill or are involved in serious accidents all the time. You never know when youll need coverage.

Some people opt for catastrophic insurance, which usually covers only major medical and hospital expenses above a specific deductible. Under such a plan, the insured pays for routine doctor visits and prescription drugs. With this type of plan, youll pay a low monthly premium but will also have a high deductible and limited coverage. Deductibles start at $500 per year but can be considerably more. If you purchase an inexpensive policy with a $10,000 deductible and you undergo surgery that costs $8,000, you must pay that $8,000. If your surgery costs $12,000, you would owe $10,000.

One insurance company offers a plan that costs $29 per month for a 21 year-old, non-smoking female. Theres a yearly $250 deductible and $2,500 in out of pocket expenses that the insured must pay before the policy kicks in. Hospital, surgical and x-ray expenses are covered but other costs, such as doctor visits, prescription drugs, maternity care and mental healthcare are not included. Theres a lifetime maximum of $1 million.

Its certainly a bargain, if you dont plan on going to the doctor very often. To enroll in a plan that will cover doctor visits, prescriptions, maternity expenses and more could easily cost $400 per montha jump of $371 every 30 days for a total cost of $4,800 per year!

Group health insurance plans, which you can usually enroll in through your employer, union or guild, are the best buy. Individual plans, especially those that offer comprehensive coverage, can be crippling to many peoples pocketbooks. When buying health insurance, its important to shop around. Your choice of what type of plan you purchase will be determined by what you can afford and what you need as far as insurance is concerned. Theres no right or wrong choice when it comes to health insurance but at the very least you should have catastrophic insurance.

There are basically three types of plansFee-For-Service, Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). Fee-For-Service plans offer the most choice regarding doctors and hospitals but they often involve quite a bit of paperwork and are the most expensive. If youre willing to give up some or a lot of choice, do less paperwork and save some money on premiums then either a HMO or a PPO is for you.

A HMO offers the least amount of choice, involves co-pays, has the least amount of paperwork and is the cheapest of the three types of insurance. A PPO combines some elements of Fee-For-Service and a HMO. Youll have more choice than you would with a HMO but less than you would with a Fee-For-Service plan. It tends to be more expensive than a HMO but less expensive than Fee-For-Service. All three types of insurance have some aspect of Managed Carewhich determines how much health care you can useattached to them, with Fee-For-Service having the fewest restrictions and a HMO being restricted the most.

When shopping for health insurance ask the following questions

* How much is the premium?
* What services are covered?
* What are the total deductible and out of pocket expenses per year?
* How much are the co-pays?
* What is the maximum lifetime benefit?
* How much freedom will you have when choosing doctors and hospitals?
* What are the pre-approval procedures for seeing specialists, undergoing a procedure or being given a test?
* What prescription drugs are covered and to what degree?
* Is mental health covered and to what degree?
* Is dental covered and to what degree?

As you begin to narrow down your choices, you can look more closely at specific plans that seem to fit your needs and determine which offer you the best value for your dollar?

America has one of the finest healthcare systems in the world and one of the most complex health insurance systems across the globe. Often, they seem to be at odds with one another, unable to communicate and work together. That can be one of the most frustrating parts of anyones foray into the world of healthcare professionals, hospitals and health insurance companies. For this reason alone, its important that you carefully and thoughtfully choose your healthcare benefits provider.

Whole Life Insurance, Trends, and Staying Power

Whole life insurance provides customers with a life insurance policy that will help their loved ones in the future, and with an investment component that will help customers and their families right away. This mixture of delayed and instant gratification has been attractive to life insurance shoppers for decades, but todays trend in life insurance is moving away from whole life insurance packages. Once, whole life insurance policies were the standard, but today they are the exception.

As the economy changes and the American public become increasingly savvy about money management, the full service that a whole life insurance policy provides just isnt as necessary as it used to be. People who want a more hands on approach to investing are likely to find a whole life insurance policy too limiting. And, the amount of money that one of these policies requires each month can make it difficult to pursue other investment options, especially for middle and lower class families who are living on a budget. A lot of financial experts today feel the investment portions of whole life insurance policies do not offer customers the best return rate on their money. This provides an incentive for people to purchase term life insurance policies which do not include any investment components, and then invest their money elsewhere.

However, there are still some advantages to purchasing a whole life insurance policy. Although the investments that an insurance company will make on your behalf may not be the most lucrative, they will almost certainly be among the most stable. Many people prefer a lower rate of return with a lower chance of loss rather than a riskier gamble. There is plenty to be said in favor of this perspective, especially when it comes to planning for the future. In addition, people who do not have the discipline or inclination to save money on their own often find the structured saving a whole life insurance policy requires to be a boon.

If the idea of budgeting your own savings plans and spending time researching hot stock tips appeals to you, a whole life insurance policy probably wont be to your personal taste. Of course, even if you dont opt for this tried and true kind of policy, you can be certain that someone else will. Although todays trends seem to foretell the end of the whole life insurance policy, there are still enough customers interested in this kind of traditional and conservative policy that insurance companies will be likely to offer this kind of coverage for many years to come.

About 50 years ago, health insurance started to be an attractive incentive offered by employers to attract and keep good employees. Overall, group plans tended to be inexpensive for employers, with employees contributing a small amount of money or none at all to secure health insurance for themselves and their families.

It was more expensive for individuals to pay for non-group policies, but coverage was fairly affordable. Then medical costs started to rise, people started to live longer and the medical profession became adept at curing various diseases and saving and prolonging the lives of people with serious injuries and life-threatening illnesses. Health care and insurance prices started rising much more quickly than annual incomes and premiums began taxing both employers, who were paying the lions share of premiums, and for employees, to whom businesses often passed on costs through larger deductibles, greater out of pocket expenses and higher premiums.

According to a recent report by the MSNBC News Service, 41 percent of Americans whose income ranges from moderate to middle had no health insurance for at least part of 2005. In 2001, that number was much lower28 percent. Additionally, more than 50 percent of uninsured Americans in 2005 found it difficult to pay their medical bills. Another alarming statistic28 percent of Americans in 2005 had no health insurance, while 24 percent had none in 2001.

So, what should a person do if they dont have any health insurance or if they have a choice between a cheap discount plan that does not cover core expenses and an affordable plan that may cost a bit more but also provides much better coverage? According to data from the U.S. Centers for Disease Control and Prevention, the majority of people who are not covered for important screening tests, such as a mammogram, colon cancer screening or a PSA test, will not undergo those exams. Also, close to 60 percent of people without health insurance missed treatment or did not buy medicine needed for a chronic condition.

All of these figures point to one thingpeople who lack health coverage for essential services are often unable to pay for those services, putting them at greater risk for developing new or exacerbating existent health conditions.

What should you look for in a health insurance plan, especially when cost is an issue? Its important that you get the best coverage you can afford. Skimping on premiums can save you money upfront, but the result can prove to be penny-wise and pound-foolish. Sometimes people cant afford coverage and sometimes they believe because they are healthy that they simply dont need it. However, healthy people get ill or are involved in serious accidents all the time. You never know when youll need coverage.

Some people opt for catastrophic insurance, which usually covers only major medical and hospital expenses above a specific deductible. Under such a plan, the insured pays for routine doctor visits and prescription drugs. With this type of plan, youll pay a low monthly premium but will also have a high deductible and limited coverage. Deductibles start at $500 per year but can be considerably more. If you purchase an inexpensive policy with a $10,000 deductible and you undergo surgery that costs $8,000, you must pay that $8,000. If your surgery costs $12,000, you would owe $10,000.

One insurance company offers a plan that costs $29 per month for a 21 year-old, non-smoking female. Theres a yearly $250 deductible and $2,500 in out of pocket expenses that the insured must pay before the policy kicks in. Hospital, surgical and x-ray expenses are covered but other costs, such as doctor visits, prescription drugs, maternity care and mental healthcare are not included. Theres a lifetime maximum of $1 million.

Its certainly a bargain, if you dont plan on going to the doctor very often. To enroll in a plan that will cover doctor visits, prescriptions, maternity expenses and more could easily cost $400 per montha jump of $371 every 30 days for a total cost of $4,800 per year!

Group health insurance plans, which you can usually enroll in through your employer, union or guild, are the best buy. Individual plans, especially those that offer comprehensive coverage, can be crippling to many peoples pocketbooks. When buying health insurance, its important to shop around. Your choice of what type of plan you purchase will be determined by what you can afford and what you need as far as insurance is concerned. Theres no right or wrong choice when it comes to health insurance but at the very least you should have catastrophic insurance.

There are basically three types of plansFee-For-Service, Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). Fee-For-Service plans offer the most choice regarding doctors and hospitals but they often involve quite a bit of paperwork and are the most expensive. If youre willing to give up some or a lot of choice, do less paperwork and save some money on premiums then either a HMO or a PPO is for you.

A HMO offers the least amount of choice, involves co-pays, has the least amount of paperwork and is the cheapest of the three types of insurance. A PPO combines some elements of Fee-For-Service and a HMO. Youll have more choice than you would with a HMO but less than you would with a Fee-For-Service plan. It tends to be more expensive than a HMO but less expensive than Fee-For-Service. All three types of insurance have some aspect of Managed Carewhich determines how much health care you can useattached to them, with Fee-For-Service having the fewest restrictions and a HMO being restricted the most.

When shopping for health insurance ask the following questions

* How much is the premium?
* What services are covered?
* What are the total deductible and out of pocket expenses per year?
* How much are the co-pays?
* What is the maximum lifetime benefit?
* How much freedom will you have when choosing doctors and hospitals?
* What are the pre-approval procedures for seeing specialists, undergoing a procedure or being given a test?
* What prescription drugs are covered and to what degree?
* Is mental health covered and to what degree?
* Is dental covered and to what degree?

As you begin to narrow down your choices, you can look more closely at specific plans that seem to fit your needs and determine which offer you the best value for your dollar?

America has one of the finest healthcare systems in the world and one of the most complex health insurance systems across the globe. Often, they seem to be at odds with one another, unable to communicate and work together. That can be one of the most frustrating parts of anyones foray into the world of healthcare professionals, hospitals and health insurance companies. For this reason alone, its important that you carefully and thoughtfully choose your healthcare benefits provider.

Battling an Unfair Health Insurance Claim Can Really Pay Off

Are you having trouble getting your insurance company to pay your medical health costs? Join the club. When managed care entered the insurance scene a decade ago, its mandate was to contain rising medical costs. One way to do that is to deny claims, even when claims are legitimate. The consumer backlash led to many states establishing independent review panels and requiring insurance companies to develop in-house appeal procedures. Forty-two states now have independent review boards whose decisions can override those of insurance companies. Most consumers don’t even realize these review boards exist.

Another problem is that too many people just give up when their insurance claim is denied initially. The appeals process can be long and frustrating and many people don’t have the patience or time to pursue a claim no matter how legitimate. People must be persistent and they can win. Particularly if there’s substantial money involved, the time you dedicate to appealing insurance company decisions can pay off usually more quickly than you think. A Kaiser Family Foundation study recently found that 52% of patients won their first appeal for each claim made. The insurance companies aren’t getting with out paying anymore.

If your first appeal gets turned down, press on. The study found that those who appealed a second time won 44% of the time. Those who appealed a third time won in 45% of cases. Which means the odds are in your favor no matter how long it take. Remember that every time you appeal it costs the insurance company more money to fight you and they are not only going to lose money to you, but also in court costs. Medical health benefits are particularly tricky because insurance companies usually have a cap on the amount of money they’ll spend in a given year, or on the amount of visits they’ll pay for. But there’s often some flexibility when you can document that you or your child’s health warrants more care than your policy usually covers. Here’s how to get started:

Do Your Homework

Read your Policy: What are the benefits? Which kinds of services are included? Outpatient or inpatient care? Is it a serious or “non-serious” diagnosis?

Know the law: Contact your local Health Association to determine your states legal requirements regarding insurance payments for all illness. Does your state require full or partial parity? Are parity benefits available only to patients with “Serious Illness” or is a so-called non-serious illness also included?

Provide written documentation: Some insurance companies may not consider some diagnosis’s serious. In this case, you will need documentation to validate required services. Obtain a letter of medical necessity from your doctor and get test results showing the medical need for you or your child to receive certain services, based on the diagnosis.

Keep good records: Remember, you’ll be dealing with a bureaucracy. Keep the names and numbers of everyone with whom you speak, the dates on which you spoke, and what transpired in the conversation.

Start early: If you can, start the appeals process prior to initiating treatment. If the doctor says your child will need to be seen once a week for a year, begin immediately to appeal your insurance company’s policy of reimbursing only 20 visits a year.

Call and Ask the Insurance Company:

What are the prerequisites for receiving health benefits?

How many visits are allowed annually for you or your child’s diagnosis? Can multiple services be combined on one day and be counted as only one day or one visit?

Which services must be pre-certified–by whom?

Be positive, polite and patient with the customer service representative. Remember that he/she is only the messenger, not the decision-maker. They are the gatekeepers and can either provide you with access to a decision maker or make your life miserable, depending on how you interact with them.

Be persistent. There are no magic bullets. Be like a dog with a bone and don’t give up until you get the answer you want. If you get nowhere after several calls, ask for a supervisor or a nurse in the pre-certification department.

Remember that you do have the right to appeal if your claim is denied. Most consumers get discouraged and will not continue to pursue a claim that should or could be paid. Insurance companies count on that happening, so get out there and claim what’s justifiably belong to you.