Insurance covers any damage incurred on property or life incurred, but sometimes your claims can be denied by the company. There are so many cases of denied claims which resulted in total loss and damage.
If you are a victim of a denied claim. Here are 6 tips that will help you handle such a case.
A situation where the insurance company denies claims for compensation after loss or damage. Such acts can be due to wrong information provided, inaccurate details, and non-covered services, among others.
Denied claims can only be reconsidered after due research has been done to determine the denial’s errors and reasons. Afterward, the complaint appeals and may be reconsidered.
If you’re in this situation, here are things to do in handling denied claims.
Always review all notifications from the insurance company regarding a denied claim, explanation of benefits, or remittance. If your claim is denied, there will be stated rules of engagement and required processes to follow, which must be stated by the company.
Do well to follow the stated processes in resubmitting your claim to avoid getting denied. For clarification, put a call to the insurance representative.
When you discover your claim is denied without a tangible reason, you can make an appeal based on the payer’s guidelines and that of your state of residence.
Your appeal should contain relevant information like documents from initial communication, supporting documents, and your request for reconsideration.
Be sure to submit an appeal to oppose the company’s decision consistently without any drawback.
The insurance company will specify dates meant for the submission of appeals or claims. Always keep to time. A delay may lead to your claims or appeal being judged as untimely and may never be reconsidered.
Before filing an appeal, get to know the reimbursement policies of the payer, this gives you an upper hand when responding to feedback. You can provide hard copies of the payer’s policies and billing guidelines as supporting documents whenever you sign a new contract with them.
In the process of submitting claims and appeals to the company, keep every valuable record and document backing up every step taken in the process.
These records will play a key role when you need to make an appeal to higher authorities, like the insurance commissioner in your region, a law court, or when pursuing litigation.
Keeping records will help exonerate your company from future accusations that can damage your goodwill.
The process of handling insurance claim denials is overwhelming and time-consuming. Hence when the going gets tough, hire an expert.
Receiving advice from a professional will help you avoid some unnecessary procedures and avoidable mistakes. You can contact the state insurance commissioner in your region for guidance or professionals in the insurance field.