{"id":355809,"date":"2018-09-12T11:39:46","date_gmt":"2018-09-12T16:39:46","guid":{"rendered":"https:\/\/ability-fl-prod.internetbrands.com\/ability-law\/healthcare\/patient-rights\/health-care-and-bad-faith-insurance-claims.html"},"modified":"2026-08-17T17:49:00","modified_gmt":"2026-08-17T22:49:00","slug":"health-care-and-bad-faith-insurance-claims","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/health-care-and-bad-faith-insurance-claims.html","title":{"rendered":"Health Care and Bad Faith Insurance Claims"},"content":{"rendered":"\n
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Health Care and Bad Faith Insurance Claims<\/h1>\n\n
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\n By Susan Buckner, J.D.<\/a> | Legally reviewed by Susan Mills Richmond, Esq.<\/a>\n | Last updated\n
\n \n <\/i>\n Legally Reviewed\n <\/summary>\n\n
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This article has been written and reviewed for legal accuracy, clarity, and style by FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with our editorial standards<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n\n

\n \n <\/i>\n Fact-Checked\n <\/summary>\n\n
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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n\n\n

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Key Takeaways<\/h2>\n
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A bad faith insurance claim arises when your insurer wrongfully denies or delays payment on a valid health insurance claim. These cases often involve poor investigations, unfair settlement tactics, or violations of your policy\u2019s duty of good faith and fair dealing. If this happens, you may be able to appeal the denial, pursue an ERISA review, or sue the insurer for bad faith to recover what you\u2019re owed.<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n <\/div>\n <\/div>\n<\/div>\n\n\n

When you purchase a health insurance policy, pay your premiums, and file a health insurance\u00a0claim, you expect your health insurance company to pay your medical bills. That’s why you have insurance. You don’t expect a notice telling you the company denied your claim. A claim denial letter can make your personal injury feel much worse.<\/p>\n

If your insurance company denies your claim without a good reason, there are options available. You may be able to file a civil claim against the health insurance company for\u00a0bad faith<\/a>. For the best shot at a successful suit, you’ll want to get help from an experienced attorney<\/a>.<\/p>\n

Keep reading to learn more about bad faith healthcare insurance claims.<\/p>\n

Bad Faith Insurance Claims<\/h2>\n

An insurance claim can be\u00a0denied for legitimate reasons<\/a>.\u00a0For example, the amount of the claim may be below your deductible. In a personal injury claim, you may need to file a claim against the other driver’s auto insurance so your insurer can bill them directly. Perhaps you forgot some documentation the insurer required. As frustrating as it may be, your insurer can deny your claim for those reasons.<\/p>\n

A\u00a0bad faith<\/a> claim arises when you had a valid claim, and your insurer wrongfully refused to pay. Some signs of a bad faith denial include:<\/p>\n