Insurance Claim Denied? Here’s What to Do Next
A denied insurance claim can be frustrating, but you have options. Follow these steps to challenge the denial and get the coverage you deserve.
1. Understand Why Your Claim Was Denied
Your insurance company should send a denial letter explaining the reason. Common reasons include:
Policy exclusions: Your situation isn’t covered.
Lapsed policy: Your coverage expired due to missed payments.
Insufficient documentation: Missing receipts, medical records, or proof of damage.
Pre-existing conditions: For health or life insurance claims.
Late filing: Claims must be submitted within a certain timeframe.
🔹 Action Step: Review your policy and compare it with the denial letter.
2. Contact Your Insurance Company
Before filing an appeal, speak with a claims representative.
Ask for:
A detailed explanation of the denial
A copy of your policy if you don’t have one
Instructions on how to appeal
Action Step: Keep detailed notes and request everything in writing.
3. Gather Supporting Evidence
To strengthen your case, collect:
Photos, videos, or witness statements (for car, home, or property claims)
Medical records and doctor’s notes (for health or disability claims)
Repair estimates and receipts (for property damage)
Police reports (if applicable)
Action Step: Organize all relevant documents before submitting an appeal.
4. File an Appeal
Most insurers allow you to appeal a denied claim within 30-60 days.
Steps to appeal:
Write a formal appeal letter explaining why your claim should be approved.
Attach supporting evidence (photos, invoices, medical reports, etc.).
Submit the appeal through the proper channel (online, mail, or fax).
Action Step: Follow up regularly and request confirmation that your appeal was received.
5. Seek Help from a Professional
If your appeal is denied, consider:
A public adjuster (for home or property claims)
An attorney (for large claims or bad faith denials)
Your state’s insurance department (for complaints and mediation)
Action Step: File a complaint with your state’s insurance commissioner if you believe the denial was unfair.
6. Consider Small Claims Court (as a Last Resort)
If your claim is small (typically under $10,000), you may take legal action in small claims court.
Action Step: Consult a lawyer to see if this option makes sense.