What should I do if my insurance claim is denied?

Question: What should I do if my insurance claim is denied?

If your insurance claim has been denied by your insurer, you should not panic or give up, but rather consider your available options. Here is what you can do if your insurance claim is denied:

1. Review the Insurance Policy

   The first step that you should take upon receiving a denial notice is to read your insurance policy carefully. Understanding your policy helps you to know precisely what is covered and to determine whether the claim was legitimately denied. If you have any difficulties understanding the policy, it is advisable to seek clarification from your insurer or an attorney.

2. Contact the Insurer

   After carefully reviewing the policy, you should contact your insurer or insurance broker to verify the reason behind the denial. At times, an insurer may erroneously deny a claim due to a mistake they made, or there was a misunderstanding with the insured. Thus, it is usually helpful to understand the reason for the denial, which can enable you to address discrepancies or file an appeal.

3. Dispute the Denial

   If you genuinely believe that the insurer wrongfully denied your claim, you have the right to dispute the decision. Typically, most insurers have dispute resolution mechanisms in place, such as an internal appeal process, which requires the insured to provide additional supporting documentation. If the denied insurance claim was denied based on a mistake by the insurer, it is likely that you would win on appeal.

4. Contact an Attorney

   Sometimes your insurer may deny your claim based on a legal interpretation or dispute, and such issues may require a legal interpretation of the insurance policy. If this is the case, you should consider consulting an attorney. By doing so, you can obtain sound legal advice and guidance during the appeal or litigation process.

In conclusion, if your insurance claim has been denied, you should seek to understand the reason for the denial and take appropriate action to address it. If you need any additional legal help during the dispute resolution process, consider seeking the advice of a qualified attorney.