What to Do If Your Claim's Denied

If your insurance company refuses to pay a claim, these tips will help you recover what you deserve.

By Jacquelyn Lynn

Opinions expressed by Entrepreneur contributors are their own.

Do insurance companies routinely deny valid claims just to avoidpaying for them? Such a scenario might make good dramatic fiction,but it's not the case in the real world, says David W. Henry,an attorney with Allen, Dyer, Doppelt, Milbrath & Gilchrist PA inOrlando, Florida. "Carriers look to get the rightanswer," Henry says. Even so, claims adjusters are human, someclaims and insurance policies are complex, and mistakes happen.

So what should you do when you think you have coverage and yourclaim is denied? Henry, whose practice focuses on insurancelitigation, says to start with a written explanation from theinsurer. "Insurance companies normally provide thisautomatically," he says, "but if they don't, insiston it." You can also ask that a supervisor review the claimdecision.

Take the denial letter to your insurance agent and see whetherhe agrees with the carrier's decision. "Sometimes, aknowledgeable agent will know if the claims adjuster has made amistake," says Henry. If the agent agrees with the denial, andyou are satisfied with his explanation, the case is closed. If hedoesn't, he may contact the carrier on your behalf, or you maydecide to consult an attorney.

If it turns out your claim was denied because you didn'thave the coverage you thought you did, you may need to review yourpolicy and examine your relationship with your agent.

Jacquelyn Lynn is a freelance business writer in Orlando,Florida.

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