What to do if my claim is denied

First, read the letter you received from the insurance company and find out why they have denied your claim. Their reason may be something as simple as a clerical error, or they may be missing a key piece of paperwork. In many cases they require a form to be filled out by your doctor before making a decision – if that is the case, you should immediately make arrangements with your doctor and make sure the insurance company has all the forms it needs to process your claim.

The insurance company may also have refused your benefits due to an issue with your employer. In that case you should contact your employer immediately because the employer is often able to assist you in getting the insurance company to fairly process your claim. If you have submitted all proper paperwork and your doctor supports your claim, but the insurance company still refuses your claim, you have two remaining courses of action: doing an internal appeal with the insurance company, or taking legal action, which generally involves suing the insurance company to obtain your benefits.

If you have submitted all proper paperwork and your doctor supports your claim, but the insurance company still refuses your claim, you have two remaining courses of action: doing an internal appeal with the insurance company, or taking legal action, which generally involves suing the insurance company to obtain your benefits.

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