When your insurance claims are denied, it is your duty to contest your insurer. But in most of the cases, the rate of success was 50% for the consumers. Also in most of the cases, the denial shows that the claim was denied due to some kind of error.

Most of us actually don’t know how to fight denied insurance claims.

We are unaware of the fact that the insurance providers tend to use many cheap tricks to avoid paying out the claims.

For this reason, insurance policies are made extremely long and written in a language that is nearly impossible to understand for a common people.

Most of us don’t have the time to read such long terms and conditions, so we blindly trust the insurance agent and sign up for the policy.

We do believe that we are getting benefits worth our invested money.

But this isn’t the truth. After paying so many premiums, when you claim your rightful money, they will show you some “good” reason to deny your claim.

And it is also a fact that nearly two-thirds of the people don’t know how to contest against them or how to get help from an attorney.

So, how to fight denied insurance claims?

Here are are the things you should remember first:

a. Submit proper documents

You have to submit an internal appeal within 180 days of receiving the explanation of benefits letter (EOB).

You must write a letter to the insurance company by mentioning  the claim number and the policy number. You can also use the claim appeal form provided by the insurance company.

If you have any doubt, call the insurance provider and ask how to submit your claim appeal properly.

b. Behave calmly

Having a claim denied is depressing. But remember, the person you are calling regarding your case may not be the actual person responsible for the denial. Maybe some other guy raised any issue with your claim.

So, behave nicely to the associate who is taking your call and explain him/her about your situation.

c. Follow up regularly

Most of us had called the insurance company once our claim denied and then forget about it.

Don’t do that.

Set up a reminder to follow up with the customer service agent. Make notes of the dates you need to call them.

It is good to put a gentle pressure on  the company with regular follow up.

d. Always start with the easy problem

Before contesting your insurance provider, you need to recognize and understand the loophole “Why the insurance claim was denied?”

The insurance provider will send you an EOB letter to you whenever you file a claim. The letter will contain a code which explains the reason for  your denial.

If you have doubt, call the company for answers.

They are bound to explain the situation in terms you can recognize the problems.

If it’s just because of some silly data mistake, like wrong insurance policy ID or wrong name, rectify the errors asap. If the issue is major, call the concerned person, make it correct, and resubmit your claim.

If the issue isn’t from your end, gather proper documentation to prove that to the insurance company.

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