People buy insurance policies based on the belief that the insurer will come through by delivering on the promise of their coverage when it is most crucially needed.
On the other hand, the insurance companies make a lot of money by striving to reduce claim payouts, so they may not be cooperative enough. That is not to say you should take “no” for an answer if your insurance provider initially dismisses your claim.
Find Out Why
Normally, you will receive an official letter from your insurance provider if it declines a claim. This could be due to the firm’s belief that your policy does not cover your specific situation, which is a common cause for refusal.
The next step is to take an in-depth look at your policy, particularly the section about denial of coverage. This will help you determine if the company’s denial is justified or there has been a mix-up.
You could also seek further clarification from your insurance broker, but keep in mind they rarely have the authority to overturn the decision of the company.
Get in Touch with the Claims Department
If your investigation leads you to believe your insurance provider wrongfully declined your claim, then you need to contact the claims department for more details.
Contact information should be included in your refusal letter, as well as your insurance card or other coverage documentation as well as a list of all your questions ahead of time, and keep your cool during the discussion. A minor clerical error or another easily correctable issue may have resulted in the denial in some situations. And if you are not pleased with the responses you got, request a meeting with the supervisor.
Consider filing a formal appeal if you haven’t made any progress. The information on how to begin the appeal procedure should be included in your policy or refusal letter. You’ll almost certainly need to submit your appeal in writing, along with any supporting paperwork. In general, appeals must be filed on time, so waste no time in getting this filed.
Department of State Insurance
This is like a mini-last resort in case your insurer rejects your appeal, which is very likely. If this is the case, you should seek assistance from your state’s insurance department. Consumer complaints are usually handled through a formal process in most insurance agencies.
Time limits for submitting a complaint are usually the same as for filing a formal appeal. If this fails, or if your state does not provide this service, you may need to seek professional arbitration or perhaps go to court to address the issue.