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What to Do When the Insurance Company Denies Your Claim


Insurance companies are no different than any other business on the market. Their goal is to make a profit, and most of the time, they do whatever they can to secure it. And what better way to keep all this profit in their pocket than by denying your claim. But worry not, in this article, you will have a look at some of the things you can do when the insurance company denies your claim.

Know Your Rights

The first and most important thing you need to know when the insurance company denies your claim is your right to appeal this decision. Whether your insurance provider refuses to pay your claim or finishes your coverage abruptly, you are entitled to appeal this decision and to have it reevaluated by a third party. Insurance companies are required by law to inform you about why they chose to deny your claim or end your coverage. At the same time, they have to tell you how you can counteract this decision.

Go by the Law

This probably comes as no surprise, but insurance companies have to abide by a series of specific laws and regulations. These laws state that they have to handle your case as thoroughly as possible and with the best intentions in mind. If the insurance company denies your case, you can ask them for an internal appeal. An internal appeal means that they have to lead a complete and transparent review of its verdict. All of this must happen promptly, even more so if the case is urgent.

The second option you have is to ask for an external review. If this is the case, then you are entitled to take your claim to an independent firm to have it reevaluated. At the end of the investigation and evaluation from this third party, your insurance company will no longer have a say regarding the payment. They will have to comply with the verdict of the external review.

Conduct Your Own Investigation

Although the insurance company is required to conduct a thorough investigation regarding your case and your appeal, you want to gather as much information as possible. This is especially important if you fail to reach an agreement with the insurer, and you decide to take things to court as lawsuits can be very costly and time-consuming.

Get Professional Help

Where there is a case, there is always a chance for insurance coverage disputes. And because of the vast amount of rules and regulations regarding insurance claims, seeking professional help is a must. An insurance attorney can help you get the best results in the shortest possible time frame. If appealing the insurer's decision is not enough, a lawyer can also help you file for a lawsuit and represent your case in court.

Finally, if an insurance company denies your claim, then worry not, now you know the first steps towards overturning their decision.

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