Where can I find a medical professional to help with an insurance claim?

[Coronos]

My father had a critical illness insurance policy that covered, among several other things, heart attack and kidney failure. He passed away with multiple health issues, including these ones.

Due to the circumstances of his health and hospitalization, the information needed to prove he suffered from these issues is unclear. The final doctor’s report stated that he had heart failure, but it must be a heart attack to be covered. Renal failure must require regular dialysis to be covered. My dad was recommended for dialysis, but had too many other issues, and passed away before receiving it.

I requested records that mentioned heart or kidney issues from the hospital archives, and received over 200 pages of records from the three different hospitals he spent time in. There are pieces of evidence scattered throughout, but no clear statements with the supporting lab test required. There are doctor’s comments that indicate he *may* have had a heart attack, and some tests that would support it, but it’s hard for a regular person to know what information might be relevant and what isn’t.

My question is this: Is there any medical professional whose job is to help people gather the records and information needed to satisfy an insurance company’s requirements for a claim?

[Kirstie_MHModerator]

Hi there - this site and the forums are only able to focus on the medical aspects of conditions and diseases.  We aren't able to advise on matters of insurance and other bureaucracy.  We hope you find th4e help you are seeking, but we aren't able to address those concerns in our medical forums.

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[specialmom]

Gosh, I don't think you really need a doctor as his providers documented his cause of death and it wasn't a heart attack and he didn't have dialysis. Those two requirements weren't met. You really need an attorney if you want to fight this and they can then find experts to look at the documents.

[Coronos]

There are so many more details that I have left out, many of which would indicate that he did have a heart attack. And the fact that he didn't receive dialysis isn't relevant. The fact that he needed it is.