How to File an Insurance Appeal
Insurance denials can have devastating consequences for you and your family. Whether you are trying to collect on a life insurance policy or get medical treatment covered, the result of an insurance denial can mean severe hardship or, at worst, financial ruin. As a consumer, you have important rights when it comes to claim denials, and that includes the right to appeal your denied claim with your insurance company.
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Instructions
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Contact your insurance company to ask for the specific reason for the insurance denial. Although you should have received a notice of claim denial in the mail, it may not be clear from the letter exactly why the claim was denied. Knowing the full facts will enable you to craft a good appeal.
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Ask your insurance company about how to file an appeal. The claims appeal process differs from company to company and may require you to fill out a specific form. In addition, you may need to send the claims appeal to a specific address and file by a certain date. Your insurance carrier may have other requirements, like including the policy number and the social security number of the claimant.
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Draft a letter to your insurance company appealing the claim or fill out the required form. Make sure you are clear about the reasons for your appeal and provide proof of eligibility or other evidence that could bolster your claim. For example, if your claim was denied for nonpayment of your premium, send in copies of bank statements or check stubs proving that you did in fact pay the premium.
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Wait for the insurance company to respond to your appeal. This may take several weeks, but you should receive something in writing. If the letter confirms the denial, you may wish to consult an attorney regarding your claim.
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Tips & Warnings
You may be able to get help filling out an insurance appeal from your state. For example, Michigan's Patient's Right to Independent Review Act provides free assistance for appealing denied medical claims.
