My Valid Insurance Claim Was Denied. What Should My Next Step Be?

Insurance companies deny tons of claims every day. When this happens, the next step is to review the policy’s fine print to make sure there wasn’t an error on your part and resubmit. If that doesn’t work, you can contact the company to see what the problem might have been. If this fails, it’s time to hire a seasoned Fort Lauderdale insurance attorney

Insurance Claim Denials

Denials of claims can hinge upon several factors. While outliers do exist, most of the factors fall within an average range of scenarios. 

Why Did My Insurer Deny My Claim?

Insurance companies’ denial of claims can happen for several reasons. All claims filed within the guidelines laid out by the company are valid. Sometimes, other factors come into play when denials are issued. They include: 

  • Application discrepancies
  • Violating the law during the incident, like driving drunk
  • Being overinsured
  • Being underinsured
  • Failure to report promptly
  • Underreporting details like milage or upgrades

Steps to Take When Your Insurance Claim Is Denied

The protocol may vary based on factors like the state in which the incident occurs as well as case-by-case instances, but in general, the routine remains the same. 

Report the Claim Immediately

Reporting claims via the internet has never been more straightforward, and in most cases can be done on-scene in a matter of minutes. When this isn’t an option, most policy issuers provide several options of numbers to call and report a claim. Collecting all valid details of other persons involved at the scene is included here, and calling the police is always a 100% must. 

Securing and submitting police reports can be a big help for claims. Also, collecting as much photo and video evidence as possible is always the correct move. Thanks to smartphone technology, this is easier than ever.

Get Detailed Estimates

Present as much factual information as possible during your claim. This helps to strengthen your case. Providing multiple estimates helps to illuminate the median value range that damages can fall into and help to prevent insurance companies from underpaying you. 

Review Your Policy and Paperwork

Reading the fine print is paramount. Knowing the details of your policy may seem like a big investment on the front end, but it’s worth it to enjoy back-end security. It helps you avoid messy litigation and being taken advantage of by the insurance company.

Get the Right Answers

For every denial that’s a simple fix, there’s one that’s a headache. Having the right help is key in navigating this journey. By contacting an experienced claims attorney, you’ll be working with an expert who knows how to handle these situations. While it may be your first experience with these incidents, the right legal counsel will have seen scenarios like yours many times over.

Keep Detailed Records

Keeping detailed records is one of the most important steps to ensure your claim succeeds. If you enter into arbitration with the insurance company, it’s important to have records of dates, the nature of relationships, an activities log, the names and phone numbers of people, and company identification numbers regarding your case.

Call your doctor if your policy issuer says that medical information was excluded from your submission. You can ask the doctor to fix the error and then resubmit.

If you’re an employee with coverage, contact HR at your job to get all information valid to your claim. Health coverage details are always helpful considerations for lawyers and insurers. 

Begin the Appeal Process

When refusal to pay remains the policy issuer’s stance, you can file for an appeal. This is within your legal right, just as the right to denial is within theirs. Independent, third-party, and external reviewers will get the contract.

The appeal process must be followed to the letter. Policy appeal protocol is available on policy paperwork, or you can request it via phone call. Keep in mind that deadlines exist and are important not to miss. 

When filing an appeal, let your healthcare providers know. You can request that they delay sending you any bills until you’ve been in communication with your insurance company about the situation. This can also ensure that your account with them doesn’t erroneously end up in collections.