There are a variety of different types of insurance that can be purchased by consumers, many of which are commonly offered or provided by employers as part of benefit plans. One of the lesser known types of coverage sometimes offered by employers is hospital accident indemnity benefit insurance. These policies provide a daily financial benefit if a policy holder is injured in an accident and hospitalized. If you or a loved one has had benefits under such a policy wrongfully denied for any reason, there may be a deadline to appeal the insurer’s decision. It is important that you contact an attorney soon after the denial. The North Carolina insurance coverage lawyers of Maginnis Law may be able to assist you with your hospital accident indemnity claim. Attorneys Edward Maginnis and Shawn Howard litigate insurance coverage disputes against insurers and can be contacted at 919.480.8526.
Hospital accident insurance policies are sometimes referred to as “hap” policies. A number of life insurance companies offer these plans. The way they work is that a policy holder is entitled to a certain amount of money for each day he or she is hospitalized as the result of an accidental injury. This is called the “scheduled benefit amount.” In some policies, this scheduled benefit amount is doubled or increased by some percentage if the person is in intensive care. There may also be a one-time benefit if an ambulance was used to take the policy holder to the hospital. Policies can also cover spouses and children, although sometimes the daily benefit is less than that for the primary policy holder.
Because many hap policies are provided by employers, they are often times controlled by the Employee Retirement Income Security Act (“ERISA”). This federal law provides certain deadlines for appealing claims denials that must be followed. It “pre-empts” any state law that may apply to your claim. This is one of the many reasons that it is probably in your best interest to contact an attorney sooner rather than later if you believe your claim has been wrongfully denied.
It is important to point out that insurance companies wrongfully deny coverage every day, for a wide variety of reasons. Sometimes they say a deadline was missed, even though it may not have been. Other times they invoke policy exclusions that simply don’t apply. If you’ve reviewed your policy and believe the insurer made a mistake, you should fight for your right to the benefits. You shouldn’t just assume the insurer is correct in its interpretation. The right to coverage is why you pay your monthly premiums.
Maginnis Law can assist with hospital accident indemnity claims across the state of North Carolina, including in Raleigh, Durham, Chapel Hill, Greensboro, Greenville, Cary, Fayetteville, Winston-Salem, Wilmington, and Charlotte. Our firm offers free consultations for all potential clients involved in insurance coverage disputes and, if necessary, will travel to meet with you. Additionally, the firm may be able to handle your hospital accident indemnity case on a contingency basis, meaning you pay no attorneys’ fees unless and until we obtain a settlement or judgment on your behalf.
If you have wrongfully been denied claims under a hospital indemnity benefits plan in North Carolina, contact Maginnis Law attorney Shawn Howard at 919.480.8526 or Edward Maginnis at 919.526.0450. You may also send the details of your claim using the firm’s contact page.
