Breaking Down Denials: What Happen When Your Insurance Claim is Denied and How to Fight It
- Charlotte Burr
- Mar 17
- 3 min read
Paying your insurance premiums means your insurance company will provide financial protection when unexpected events occur. Whether it’s auto, home, health, or life insurance, these policies are meant to ease the financial strain of accidents, illnesses, or natural disasters. But what happens when the protection you thought you had suddenly feels out of reach? If you’ve ever had an insurance claim denied, you know how frustrating it can be. Here’s what you need to know about denied insurance claims and how to take action to protect your rights.
Understand Why Your Claim Was Denied
It’s important to know why your claim was denied. The most common reasons are:
Lapsed or Expired Policy
Late Filing
Misrepresentations or Errors
Improper Filing Procedures
Avoid Claims Denial Initially
To avoid insurance claim denials, it’s important to be proactive and ensure you meet all the requirements and responsibilities of your policy. Speak with an agent before filing a claim. Here are some general tips:
Familiarize Yourself with Your Coverage: Know what is covered and excluded from your policy. Don’t wait until it’s too late to find out.
Document Everything: Keep records of your belongings, home, car, heath condition, etc. with photos or receipts in case you need evidence.
File Claims Promptly: Most insurance policies have specific deadlines for filing claims, so it's important to be aware of these time frames and follow them closely. If you file a claim within the policy period and the loss occurred during that time, you should be eligible for compensation
Communicate With Your Company and Ask Clarifying Questions: If you are unsure about anything, reach out to your insurance company. Reading fine print can be difficult alone, consider speaking with an agent.
What To Do If Your Claim Was Denied
Don’t panic if your claim is denied. Appealing an insurance claim denial varies by state and company.
Examine The Policy and Denial Letter: See what should be covered and review whether the denial is valid. The denial letter should include specific reasons for the decision.
Contact The Insurance Company: Speak directly to your insurer to understand the reasoning behind the denial and whether there’s any way to resolve it. If you worked with a broker, they can help facilitate the process. Reach out to an adjuster, who can help you understand your coverage and ensure your claims are handled properly.
Conduct An Internal Review and Consider an External Review: Many insurers allow for an internal review process, where you can submit new evidence to support your claim. If that doesn’t work, consider requesting an external review, where an independent third party evaluates the case.
Hire an Attorney: If you’re still not satisfied with the outcome, consulting with an attorney who specializes in insurance law can help. They can guide you through the appeal process, though keep in mind that this option can be costly.
While there’s no guarantee that an appeal will result in a reversal, it’s often worth the effort. Many reputable insurance companies are open to reevaluating a denied claim if new, compelling information is presented. Insurers understand that mistakes or misunderstandings can happen, and they’d rather resolve issues quickly and fairly than face the costs of a lawsuit. At AZ Insurance Team, we’re committed to serving our clients and making sure you get all the benefits from your policy and claims.
Independent insurance brokerage located in Tempe, AZ. We offer auto insurance, homeowners insurance, life insurance, renters insurance, commercial insurance…
Disclaimer: Coverage will vary on state, insurance company, and type of policy
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