What is a Healthcare Lawyer?

Healthcare lawyers in Kenya specialise in healthcare issues. Plans provide customers with medical care packages and insurance plans. There are numerous healthcare plans, which may also be referred to as health insurance or health care.

Health care plans can be obtained through private health insurance companies, coverage provided by an employer, or government assistance programs. While they have many advantages, they are also a common source of disputes, which result in numerous lawsuits each year.

Most healthcare companies are large entities that earn a lot of revenue each year. Many have their lawyers on staff or the funding to hire a lawyer to defend them in a lawsuit. The odds are not in your favour if you attempt to fight an insurance company alone without legal representation.

Why is it Important to Have a Healthcare Lawyer?

If you are having any issues with your healthcare company, it is essential to have the help of a healthcare lawyer. Disputes involving health care plans may include several topics, including:

• A denial of medical coverage for services or benefits;
• A refusal to authorise the insured individual’s hospital visit or medical procedure;
• Incorrect or excessive charges for medical services;
• Cancellation of health insurance policies without proper notice; and
• Refusal to carry over a policy when an individual changes jobs.

Disputes involving health care coverage or policies can involve many different parties, including:

• The insured individual;
• The policy provider;
• The employer;
• Medical parties; and
• Other parties.

However, in most cases, the health care dispute involves direct claims between the insured individual and their policy provider. Healthcare disputes can be complex and involve multiple parties, so having a lawyer’s assistance is extremely important.

What are Some Other Issues Related to Healthcare Law?

There are steps you can take if you are involved in a dispute regarding your health care plan. Filing your health care plan dispute can be handled using these steps:

• Obtain notice. If you were denied coverage or had your policy cancelled, be sure to get the reason for the denial or cancellation in writing. There are laws requiring insurance companies to provide notice before denying services. Additionally, it will be easier to review that decision in or out of court if you obtain paperwork outlining the insurance company’s reason;
• An internal review. Claims may be filed through the mechanisms of the healthcare organisation itself. This is called a consumer complaint. The healthcare company will provide the individual with a remedy for their losses;
• External review. In an external review, an outside agency reviews the complaint. These may be necessary when the internal review cannot fully resolve the dispute. These reviews are not available for all claims. They are usually reserved for individuals who are self-insured or who are insured through an employer-sponsorship program;
• Arbitration or Mediation. It is not unusual for an insurance contract to contain a clause that requires disputes to be resolved through arbitration or mediation. In general, insurance holders do not want to participate in arbitration because the insurance company has a pre-chosen arbitrator and no means of appeal. Mediation may be simply a means to delay trial;
• Civil Lawsuit: If the insured individual and the health insurance company cannot reach an agreement through an internal or external review, a lawsuit in civil court may be possible. In severe cases, a lawsuit may be filed before a review is filed.

Regardless of your choice to resolve your dispute, a healthcare lawyer will be an invaluable asset. Your lawyer will review your case and policy, determine the best path to resolution, and assist you every step of the way.

Additionally, the laws provide that insurance companies cannot deny coverage based on race, national origin, sex, age, or disability. Your lawyer can review your case to determine if your insurance companies have violated these laws.

What are the Benefits of Hiring a Healthcare Lawyer?

There are many benefits to hiring a healthcare lawyer. If you have any disputes with your health insurance provider, a lawyer will help you to resolve your claims in the best possible manner. Your lawyer can review your policy and advise you regarding local laws. An experienced healthcare lawyer will understand the many factors involved in healthcare plans and help you obtain relief for any losses you have suffered.

Remote Healthcare Lawyers in Kenya

Our lawyers work remotely, which not only helps to reduce costs but also provides us with the flexibility to engage with businesses from anywhere in the world. Rayness Analytica has years of experience in remote engagements, supporting onboarding and managing thousands of remote relationships.

If you have further questions or concerns, please contact us through our Contact Us page. We aim to become your preferred choice for online healthcare lawyers in Nairobi, Kenya.