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Insurance company questions teen’s new wheelchair request

On Behalf of | Dec 20, 2018 | Denied Private Disability Ins. Claims |

In many instances, insurances companies in Florida and other states make an effort to meet the needs of families and individuals with unique care requirements. But one mother has experienced unexpected difficulties with her insurance provider about a request for a new, safer wheelchair for her 19-year-old son. The young man, who has cerebral palsy, has been using a wheelchair practically all of his life, but it recently fell into disrepair. While he has been using a donated scooter to get around, it presents some mobility challenges for the man.

Oftentimes, it’s cost that’s at the heart of denied private disability claims like this. In this case, the insurance company requested cost comparisons. After submitting the requested documentation, the claim was subsequently denied based on the assertion that the man’s original chair could be repaired. His mother contends that the chair he’s using has nothing to prevent him from falling, which increases his risk of sustaining an injury, especially during months when there’s likely to be inclement weather.

In one of the letters the insurance company sent, they claimed to need more physician information to grant the request for a new chair. However, a representative from the company attempted to call the man’s doctor but was unable to get a hold of anyone due to “excessive wait time.” The case has advanced to the appeals process, which usually takes about 60 to 90 days. While the insurer has received all of the claimant’s information, they won’t comment on the issue due to privacy concerns.

With denied private disability claims, an attorney may be able to take steps to address the matter if it’s a so-called “bad faith” insurance claim. This is a term that refers to unfair insurance company conduct, such as unreasonably denying a valid claim. If a case of this nature is won in court or settled in a way that’s mutually acceptable to all parties, the affected claimant may be able to recover policy benefits for the claim. Compensation for consequential losses and damages is sometimes awarded as well for emotional distress, legal fees, and lost wages.