How To Appeal Denial Of Insurance Benefits

Posted on: 28 January 2015

When you go to apply for health insurance, you expect to be approved right away. However, there are some cases where you are denied benefits for a number of different reasons. If you have been denied health insurance benefits, the following information can help you appeal the decision.

Read the Denial Papers

If you were denied insurance benefits, they most likely sent you papers in the mail, which should go into more detail about why. Look through the papers and find out what the cause was. If you believe it is an unjust case to deny you health insurance coverage, you can then look for instructions on filing an appeal. Most of these denial papers already come with instructions on how to appeal their decision. Read it carefully and follow the instructions exactly.

Get Your Paperwork Prepared

Before you appeal the decision or contact a lawyer about the denial and appeal process, you need to have all your records and paperwork in order. You should have printed documents from when you first applied for insurance, as well as copies of the appeal papers. You also want to find other types of records, such as bills from your insurance provider, any letters from the doctor providing you care, and your medical records if you can get them.

Contact Your Employer

If you receive health insurance benefits through your employer and were still denied health insurance coverage, contact your employer or human resources department right away. In most cases, they will allow all employees to be covered, regardless of your situation, medical history, or conditions diagnosed prior to having health insurance. If you were denied coverage, they need to know right away.

Explain Your Argument

When you are ready to send in your appeal paperwork, start taking notes and writing out your argument. You want to convey the importance of health insurance coverage, and why you should be able to get it. Include details about your medical history and be vigilant within your argument. Explain that you are not going to give up and that you will contact an attorney if this matter is not resolved.

It is highly recommended that you get legal help if you are denied health insurance benefits. Get in touch with an attorney such as Ritter & LeClere APC Attorneys At Law to discuss this issue and to get help filling out the paperwork. They will look through your denial paperwork and get the appeal turned in, giving you your best chance at being approved.