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Medical Billing Dispute — insurance company denying valid claim

Started by anon_dev_CO · Jun 30, 2025 · 1,029 views · 15 replies
For informational purposes only. This is not legal advice. Laws vary by jurisdiction. Consult a qualified attorney for advice specific to your situation.
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anon_dev_CO OP

Quick background on my situation — any input appreciated.

insurance company denying valid claim. I've been dealing with this for about 10 months now and the situation isn't improving.

I have already consulted briefly with a lawyer but the other party is not cooperating.

What are my legal options here? Is it worth pursuing?

TL
Mod_TermsLaw Moderator

Licensed attorney — a few thoughts. Here's my take on the legal issues.

The legal framework here involves both federal and state law. At the federal level, the relevant statute. Your state may provide additional protections.

I'd recommend documenting everything in writing from this point forward. Keep copies of all communications.

JC
just_curious_driver_TX

Have you tried reaching out to your state's attorney general? They sometimes have free resources or mediation services.

JC
just_curious_homeowner_OH

This happened to me too. Have you tried filing a complaint with the relevant agency? In my case they investigated and it got resolved without needing a lawyer.

RE
RemoteWorker_EU

I've seen this play out several times in my field.

What worked for me was filing with the appropriate government agency. It took 4-8 months but was worth it.

FI
frustrated_investor_TX

Just want to point out — the statute of limitations might be a factor here. In some states it's as short as 1-2 years. Don't sit on this too long.

TC
throwaway_creator_NC

Just want to point out — the statute of limitations might be a factor here. In some states it's as short as 1-2 years. Don't sit on this too long.

PB
PatentAgent_Boston

I went through almost the exact same thing.

What worked for me was escalating to a supervisor/manager. It took 1-3 months but was worth it.

FT
first_time_trader_WA

I had a similar issue and ended up consulting with an attorney. It was worth the $200-300 for the initial consultation just to understand my rights.

WS
worried_student_GA

Have you tried reaching out to your state's legal aid society? They sometimes have free resources or mediation services.

CA
ConsumerAdvocate

I went through almost the exact same thing.

The biggest mistake people make in this situation is having everything documented. I'd recommend keeping a detailed timeline instead.

CA
CorpCounsel_Amy

I've seen this play out several times in my field.

I ended up filing with the appropriate government agency, which cost about $4-8 but saved me a lot more in the long run.

JC
just_curious_tenant_CA

Have you tried reaching out to your state's legal aid society? They sometimes have free resources or mediation services.

FK
FreelancerKate

Been there. Here's what I learned.

The biggest mistake people make in this situation is having everything documented. I'd recommend keeping a detailed timeline instead.

EA
EstatePlanner_AZ

I've dealt with this before.

What worked for me was escalating to a supervisor/manager. It took 1-3 months but was worth it.

OD
OpenSourceLawyer_Dan

Not a lawyer, but I have direct experience with this.

The biggest mistake people make in this situation is filing with the appropriate government agency. I'd recommend gathering evidence first instead.

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