Have you ever confidently sent a claim request only to receive an auto insurance claim denial letter? There can be a lot of insurance claim denial reasons, and the ones stated in the letter are just the ones your insurance company thinks you would want to hear. There are plenty of instances that will lead to you receiving an insurance claim denial letter like:
- You failed to submit all documentary requirements. A lot of people get lax when it comes to sending documents because they believe the checkers won’t be very strict about it or some of the papers make the information redundant. For whatever reason, do not omit anything. In fact, if possible, provide a variety of documents as back-up.
- In the case of health insurance claims denial, the top cause is insufficient or inappropriate medical evidence. The cases related to health get very complicated because insurance companies are good at questioning validity and legalities of all types of medical records. You need to be very thorough with your documents since some of it might have a counter effect on your case like pre-existing conditions.
- Misrepresentation of information becomes a major issue when the validity of your writing is questioned. Sometimes, we tend to fill out the most recent information we know of ourselves, forgetting that some of the documents we have are technically ancient and outdated. This means there will be incongruent data. Mismatches between the information on the forms you filled out and the supporting documents can be grounds for denial.
- The top and most effective reason insurance companies use for denial of insurance claims is policy coverage. You need to know the conditions covered in your policy, or you will be in for some major disappointment. A lot of people think that because a dental extraction is a medical procedure, it can be claimed under a health insurance. However, you cannot rely on the general description. You need to get to the specific details because there will be a lot of exclusions. These exclusions cannot be argued since they are in your signed contract, so once you are denied for this, you need to accept that you have not read through your policy recently.
Insurance Company Denied My Claim, Now What?
If you have received the official health insurance claim denial letter, do not panic. Calm down and read the letter. See if the reason for the denial is clearly stated and figure out if you can still do something about it or not. For instance, reasons like lack of documents can be easily corrected by providing your insurance company the lacking ones. You have to be quick on these matters because reconsideration deadlines are short and you need to provide the documents on time.
For a clear denial based on a detailed analysis of your case, you will need legal advice. First, an insurance claim denial attorney can help you understand the letter from an expert bystander’s viewpoint. He will be able to provide you with better insight on your case. Also, the lawyer will be able to check your submission and verify whether the company’s claims are just. If they are, then you will need a more serious plan of action because your insurance company clearly knows what it’s doing.
You might ask yourself the question, ‘insurance claim denial, what next’? The key here is being knowledgeable. You need to have a good grasp of the situation, where you stand, what are your options and how to fight for your claim. An experience lawyer can walk you through this process if you feel that you cannot do it alone. It is also a good assurance since you know someone who has gone through the same thing many times and have succeeded is guiding you. What is left now is that you provide your utmost support.
Finding Insurance Claims Denial Lawyers
It is easy to spot an experienced disability lawyer if they have a physical office and a company website. All you need to do is browse through their portfolio and read their specializations. This is the fastest way to do it, but you need to do more if you want to find the reliable ones.
One good way to determine reliable firms is by looking for their credentials and work history. They should have several on file. You can also point out someone with experience from someone without by just talking to them about your problem. If they give sound advice, it means they know what you’re going through with very little information to go by. Lastly, find people they have worked with. Ask for their first-hand experience with the lawyer. Find out if they were successful and how the entire process went. The best way to find out how good someone is, is to talk to the people who have received their services.
