How to Appeal an Insurance Claim Denial : Insurance Basics

Hi, I'm Karen Lee. I'm the owner of Karen Lee and Associates and a certified financial planner and a registered representative with LPL Financial. Today we'd like to discuss how to appeal an insurance claim denial. And we could be talking about a health insurance claim that was denied, a life insurance claim that was denied, any type of claim that is denied. You want to start by calling the customer service branch of your insurance company and ask them about their appeal process. Many already have online centers where you can request those forms or even fill out online the appeal process. Every company is going to have their own specific form or process for you to fill out. Typically, the appeal process is going to ask you to supply additional information than what the insurance company was able to access which caused them to deny your claim, and as well as writing a letter or memo that states why you feel your claim should not have been denied. Before you send back the information to the insurance company, make a copy for yourself and keep it at home. If you have talked to someone in customer service, write down their name, the date and the time that you spoke to them as well. Once you've got that data and you've completed the forms complete, go ahead and mail or fax it in. The next thing I would tell you is follow up, follow up, follow up. Don't let those appeal forms go into the black hole of the insurance company. Call back the customer service person that you spoke with. Ask how long the appeal process is supposed to take. Follow up again. If you are denied again a second time, ask if there's an escalated appeal process. Don't just automatically assume you have no other options. See if you can go above and beyond the protocol you've already done. I hope that answers your question about how to appeal a denied claim of whether life insurance or health insurance. Again, my name is Karen Lee. I'm a certified financial planner, the owner of Karen Lee and Associates, and a registered representative with LPL Financial.