Turned Down For What: What to do after your insurance claim is denied

Lady Calling Insurance Company

Accidents can happen to anyone. Most people know this, and this is why good insurance coverage is viewed as a necessity. It’s a way to protect yourself, your family, and your property against unexpected catastrophes.

Unfortunately, having health, home, or auto insurance is not a guaranteed solution in the event of a disaster. All too often, insurance companies will avoid paying out as much as possible to make sure their profits stay solid, even if these profits come at the expense of the policyholders they are supposed to protect.

For anyone who has filed a claim only to be denied a fair payout, there are things that can be done to help you get what you’re rightfully owed.

Review Your Policy

The first thing you’ll want to check is why your claim was denied. Go through your policy contract carefully and be sure to note any relevant language that pertains to your situation. You’ll also want to note any unclear or ambiguous language used in the policy, as insurance companies are required to provide explanations for vague wording. Insurance companies are also required to clarify and provide reasoning behind the amount of coverage approved or denied. You will want to carefully read this explanation and keep a copy easily accessible for reference.

Check Your Claim

Review a copy of the filed claim and make sure that you provided all of the necessary relevant information and that all of this information is accurate. If you are found to be withholding information or providing false information, this can be used as an additional reason to deny your claim.

File an Appeal

images (1)If you believe that your claim should rightfully be covered under the terms of your insurance policy, you will probably want to file an appeal. Be certain to take note of any appeal deadlines, as missing the appeal window will stop your quest dead in its tracks.

Your appeal letter should be well-written and researched. You may want to talk to relevant parties (such as a doctor) to have them write a letter on your behalf as well. It is also a good idea to have a third party double-check your letter to make sure that your reasoning is sound and your case fully and fairly stated.

Hire a Public Adjuster

It is wise to hire a public adjuster before filing a claim for the first time, although many policyholders feel confident that their situation will be quickly and fairly solved by the insurance provider. While hiring a public adjuster from the get-go can be a good way to expedite the process and make it more likely policyholders will see favorable results, it’s not too late to enlist the help of a claims adjuster even after the claim has been denied.

Public adjusters are familiar with the system and familiar with the loopholes many insurance companies will try to use to avoid paying out. Even better, many public adjusters are only paid after your claim has been approved, so you aren’t risking ending up even more in debt. A good public adjuster should be able to evaluate your policy and your situation in order to tell you the best way to proceed so you can get the compensation you need.


Public Adjusters are available to help with your insurance claim

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If dealing with a claim, include the cause of loss/damage