March 4, 2024


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Top Reasons Why Your Medical Malpractice Claim Might Get Denied 

5 Major Reasons Your Claims Are Getting Denied - MEREM Health

The insurance company or courts deny several medical malpractice claims annually. There are several contributing factors to it. Sometimes the insurance company might reject it due to lack of evidence; other times, the information or incident might not be factually correct. No matter what the reason is, knowing why medical malpractice claims are not approved can help you avoid such mistakes. In addition, sometimes you might now think that a step or information is necessary for the claim, which can result in rejection. 

So to ensure you do not make any mistakes unknowingly, always contact a medical malpractice lawyer before filing a claim. The lawyer will guide you through the legal procedure and ensure you get the compensation you deserve. 

Top reasons why your medical malpractice claims might get denied 

  1. Prior permissions are needed in some situations. 

When you go through a medical malpractice accident, you must get yourself treated again to ensure your health is in good condition. Before the treatment begins, you will need to run through some tests to detect your health issue. The insurance company approves tests like MRI and CT scans in medical malpractice claims. 

However, if an additional test is required for your treatment and you go ahead without consulting the insurance provider, it can lead to the denial of your claim. This is because the insurance company has specific tests that are listed for each person’s medical malpractice claims. So you must confirm whether the test you are about to take is included in the policy or not. 

Note that you cannot go back and change anything once your claim is denied. So it is always better to be well informed and ask the insurance company about your doubts than to face a denied claim.

  1. Some information is missing or incorrect. 

While it is known that humans make mistakes, you might make one too. But filing a medical malpractice claim with incorrect or missing information can land you in trouble even if you did not do it on purpose. Sometime you may forget to add a detail about your claim or might add the wrong price for information by mistake. In such a situation, it is best to check your claim two to three times just to be sure. 

However, sometimes you might not know that a price of information is required in your claim, and you submit it without proving it. Again you will end up with denied coverage.