How to Win Denial of Health Benefit Litigation – Part 1/ Skidmore Script

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We are fortunate in Northeast Ohio to have access to some of the finest health care providers and facilities in the world. The receipt of quality health care is not a problem, however, the payment of expenses is problematic to the patient, spouses and anyone responsible for the health care of another. If you do not have health insurance, your personal assets and income are at risk when there are unexpected health issues. If you do have health insurance, you may have to fight to enforce your heath benefit rights. When a claim is denied without justification, the insurer is profiting at the expense of your health.

The topic of how to win denial of health benefit litigation is presented in two parts. Part I, presented in the June 2003 issue of Skidmore Script, provides a candid review of the burden placed upon participants to enforce health benefits and claims governed by the Employee Retirement Income Security Act of 1974 (“ERISA”). It also sets forth the burden in claim denial litigation through the interpretive cases of the United States Sixth Circuit Court of Appeals. You must understand the burden before you can assume it.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Eric Skidmore, Skidmore & Associates, L.P.A. | Attorney Advertising

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