How to Dispute an Insurance Claim

Rejected insurance claims – whether car or health – can have devastating effects. You need money to pay for things like medical bills and groceries following a car accident or health setback. Sometimes, a denied claim can mean that you and your loved ones’ survival depends on the final decision of insurance companies.

Luckily, if your claim has been rejected, you do not have to take “no” for an answer. You should dispute the denial and fight for the compensation you deserve. Let’s look at some ways to do that.   

Disputing Car Insurance Claims

Woman talks with insurance company on the phone to dispute her claim denail

When an insurance company denies your claim, they inform you of your right to appeal and the specific reason they denied your claim. This letter should also include a deadline to submit the appeal. Once someone with the insurance company has notified you, follow these steps to learn how to dispute an insurance claim denial:

  • Research. Read through your policy to understand what is and is not covered and to pinpoint the insurance company’s mistake.
  • Contact the insurance company. Send them a claims appeal letter that explains why your claim should have been approved.
  • Hire an attorney. An attorney can perform all the above steps and handle other matters concerning your dispute. They can find discrepancies in the policy and help you decide on the best course of legal action.

Disputing Health Insurance Claims

Disputing a health insurance claim mirrors the dispute process above. When you receive your denial letter:

  • Read the explanation of benefits included in the denial letter. The denial letter will explain why the claim was denied and how to appeal. A typical health insurance claim may be rejected simply because of incorrect information like treatment codes or provider information included in the claim.
  • File your appeal. How you file will vary based on the insurance company. If you are unsure how to file, look over the denial letter or go to the company’s website.

When to Hire an Attorney

You should hire an attorney as soon as possible after an accident or health setback. You want the best chance at a fair settlement. An attorney can help you avoid the denial process altogether. If you don’t immediately hire an attorney, at the very least, hire an attorney after receiving a denial notification. 

Disputing an insurance claim is not fun. Insurance companies fight this battle every day; a private citizen doesn’t. Insurance companies have almost unlimited resources, which can wear on your patience and your pockets. That does not mean, however, that you shouldn’t fight to be treated and compensated fairly.

If your insurance claim has been denied and you need someone to fight on your behalf, contact the experienced attorneys at Timberlake & League. We can help.