How to Appeal an Insurance Claim Denial

You can’t be blamed for having a love-hate relationship with your insurance provider. Some people see them as a necessary evil because you pay and pay and then when you want to claim, they find every reason not to pay you out. 

When things go wrong like you’re involved in a car accident or in case of health insurance, you can make a claim with your insurer, but what happens when your claim is denied? It seems ridiculous that you’ve got to fight for your rights with these insurance companies, so the question is, ‘when your claim is denied, how do you appeal.

You should find out why your claim was denied, and if it seems ridiculous to you, appeal it. We look at how you can appeal a denied claim.

Check out your insurer’s website

The reason this is so important is that you don’t want to phone your insurance company and complain about something that is made clear and explained on the website. It is a good idea to understand your insurance policy coverage and the claim process. 

If you’re worried that your deadline for appealing the denial is looming while you study your insurance policy, just send them an email telling them that you are, in fact appealing the denial. Inform them that you will be sending additional information in the next few days.

 Review information regarding the claim

Whenever you receive any kind of claim information such as remittance advice, review it thoroughly. You’ll see if the claim was partially paid or paid in full or denied. 

If a claim is partially paid or denied, it should outline the reasons. It should also guide you as to the procedures and documentation required to either resubmit the claim or file an appeal. 

Get legal help

It can be frustrating dealing with your insurance company and you feel you’re inadequate because of a lack of knowledge on how the insurance industry works. Getting money paid out to you may well require the assistance of a lawyer clued up on insurance claims and denials. Lawyers know that sometimes only legal representation will get you your compensation. will help you recover your due insurance benefits by providing details of the very best denied insurance claim lawyers there are for all kinds of insurance policies.

Call the insurer

When an insurance company has denied your claim, they become very quiet and they don’t communicate with the policyholder. And in fact, your phone calls and emails may even be ignored. It’s this kind of behavior that causes so many people to resort to legal options.

Nonetheless, don’t procrastinate – make attempts to call your insurance company and ask them why your claim on such and such a date was denied.

There are several reasons insurance companies deny claims. Some reasons are valid, but most times, they are just trying to get out of paying you. As you talk to the person, be making notes all the time and take down the name of the person you’re talking to. Record your conversation if needs be. 

Collect evidence

To support your appeal, you require some evidence. For instance, if you are appealing a medical claim, get a letter of support from your doctor as well as documents laying out details of your medical condition.

Also, you will need a letter explaining your claim and why you believe the claim shouldn’t have been denied. Your appeal letter should be accompanied by any evidence you have collected, of which you should have made copies for your own reference. 

To avoid any undelivered letters or any delays, make sure to follow the instructions of your insurer about where to send the appeal.