by Guest » Thu Mar 26, 2009 10:12 am
I’ve heard that you can appeal against the health insurer if they deny your claim. I want to know the authenticity of this information. Also, what steps can be taken if the health insurer decides to deny a claim?
Posted: Thu Mar 26, 2009 11:32 am Post Subject:
All claims can be appealed...in your explanation of benefits letter, or your denial there should be information on how to file an appeal...Now if the denial is because you have no coverage that's different..
What is the basis of their denying the claim? That had to be in the letter of denial.
Posted: Thu Mar 26, 2009 01:06 pm Post Subject:
Hi,
That had to be in the letter of denial.
That's true! The first thing that you'd need to do is to collect all the documents that support your cause. It should be a combination of all documents concerning termination or denials or for that matter something that demands special attention.
Then you may contact your state dept. of insurance. You'd need to fill out their complaint form. Now, before you'd submit the form don't forget to attach the necessary documents.
Fatman
Posted: Fri Mar 27, 2009 08:30 am Post Subject:
you can appeal against them with the state insurance office.
but keep in mind that you need to keep the records (physical) of all the papers during the denial process of the claim.
if you have a good paperwork in place along with the valid reason for the claim then your battle is half won.
(i'm sorry buck i accidently deleted your other post on this thread, I believe it advised the OP to check with 'legal docs' dot com? please re-post the site address..again...so sorry to both you and the OP---lori)
Posted: Fri Mar 27, 2009 10:26 am Post Subject:
Lori has mentioned it correctly that first of you are required to find out the reason behind the claim denial. The insurance company should intimate you the reason of denial in writing. The policy document must have mentioned the appeal process. It’d also mention the date within which the appeal needs to be filed.
I’d suggest you to discuss the matter with the agent if you have any confusion about how to proceed with the appeal process.
Posted: Fri Mar 27, 2009 10:28 am Post Subject:
Thanks everyone for the replies, actually I was looking for the format to write the letter of appeal. I'd greatly appreciate any help.
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