Figuring out what your health insurance does and does not cover can be challenging under the best of circumstances. But when your child is diagnosed with autism or an autism related disorder, it can be even more difficult to determine what coverage you are entitled to under your health insurance policy.
According to the website of Wellspring, a California clinic that provides services to children with autism and related disorders, California residents should be able to obtain health insurance coverage for autism treatments, including Applied Behavioral Analysis (ABA). But that does not mean that they are always able to do so without a fight.
California law requires that autism must be treated by state regulated insurance providers “in parity” with other medical disorders. Even so, many California parents have had a very hard time getting autism treatments, especially ABA, covered for their children.
If you have received a denial letter for ABA or other autism therapy for your child, you do not have to accept it. Many insurance companies summarily deny unusual claims in the hopes that the claimant will simply give up and accept the denial. You may be entitled not only to coverage for autism services but also to damages from the insurance company for denying your insurance claim in bad faith along with compensation for developmental delays caused by putting off treatment.
In a similar case, Callahan & Blaine won a decision that constituted a significant defeat of the insurance industry’s attitude of “deny the claim” and “pay after sued” policy. In that case, an insurance company denied a life insurance claim and paid only after Callahan & Blaine filed suit on behalf of the policyholder’s widow. The final award included attorneys’ fees, emotional distress, and punitive damages for denying a claim in bad faith.
Callahan & Blaine is California’s premier litigation firm, specializing in insurance denial of claims cases. When you call Callahan & Blaine, we will use our insurance expertise to maximize the insurance proceeds for our clients. Contact us to discuss your insurance denial of claim case today.