Payment Issues in Medical Malpractice Claims

If you deserve payment for a personal injury claim and have not been able to achieve your settlement, you may want to investigate the situation. Insurance companies can pay claims late or underpay victims on purpose. As a result, you can lose thousands or millions of dollars in claim money.

Because so many locals were falling victim to this crime, the Prompt Pay Act of 2003 was created to affix penalties and make sure that insurance companies pay full and punctual payments to the victims of personal injury accidents. If you think that an insurance company has delayed or underpaid you, it is not an issue that you should take lightly. Instead, you should contact a Houston personal injury attorney to assist you.

According to the Prompt Pay Act of 2003, insurance companies are required to pay or deny a claim in whole or in part within 45 days if the claim was submitted in a non-electronic form. If the claim was submitted via the internet, then the insurance company will have 30 days. Even if an insurer wants to audit a claim, they must pay in full during the audit. In some extenuating circumstances, an insurance company may be able to gain an extension, but they will have to have a good reason to do so.

If you did not receive your claim money on-time or were denied the full amount you were supposed to receive, then you make sure to bring this up with an attorney. Insurance companies are held accountable to the Texas Prompt Pay Act, and should be held to these requirements at all times.

Insurance companies that pay the claims within 45 days after the original deadline for a claim payment will be fined $100,000 by the state government or will need to pay 50% of the different between the billed and contracted rate, depending on which is less money.

Claims that are paid between 46 and 91 days after the payment was supposed to be made will bring on a penalty of up to $200,000 or 100% of the difference between the billed and contracted rate for insurance companies.

Any insurance company that does not pay a claim until 97 to 270 days after the deadline will need to pay either $200,000 or the difference between the billed and contracted rate. As well, the insurance company will need to pay 18 percent annual interest on the amount that accrued since the time that they payment was due.

When an insurance company underpays a claimant, they can also be punished for this action. As a victim of underpayment, you are entitled to protection under the Texas Prompt Pay Act. Claims that are paid within 45 days after the deadline will be forced to pay $100,000 or 50% of the underpaid amount.

As well, claims that are paid within 49 and 91 days will bring on a penalty of $200,000 of 100% of the underpaid amount. Claims that are not paid until 91 to 270 days after the due date will cost $200,000 or 100% of the underpaid amount as well as 18 percent interest on the amount accusing from the date that the payment was due.

If you believe that you did not receive the just amount of compensation or if took months for an insurance company to finally send you your payments, you shouldn't tolerate this unprofessional behavior. Take advantage of the statutes in the Texas Prompt Pat Act today and hire a Houston personal injury attorney to represent you. Arnold & Itkin can provide you with a hardworking and dedicated lawyer who will be able to seek justice on your behalf with the insurance company who has wronged you.


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