What To Do If Your Insurance Claim Is Denied?

Thinking about What to do if your insurance claim is denied? There are a lot of reasons for your Insurance claim rejected. If it is already denied, Don’t give up your hopes. You can start a re-claiming process against an insurance claim denied.

With our previous articles, you have a better idea about what is Business insurance? Reasons Why we need insurance? Principles of insurance, how to choose the right insurance company? Insurance policy? And things to remember when buying your insurance and claiming your insurance.

Have you ever thought about what happens if my insurance claim is denied?, Still does not think about it. then let discuss What to do if your insurance claim is rejected/denied by your insurer.

Today let discuss about What To Do If Your Insurance Claim Is Denied or rejected?

What to do if your insurance claim is denied man touch head with damage car to get claim
Why and What To Do If Your Insurance Claim Is Denied?

what is an insurance claim?

An Insurance claim is a formal request to an insurance company for money after an unexpected and major loss. Insurance claims protect people from financial losses after dealing with accidents, damages or disasters.

After happening the damage or accident or disaster, first, you need to inform it of your insurer. Also, you need to submit an insurance claim request form with the proofs. Then, they will evaluate your claim request and they decide the claim value and pay it. then the insured will get his payment. But sometimes the insurer decides to not pay and they reject the claim request.

That puts people who have already lost something worth to them in an even worse position. Because of the different reasons, you may lose your insurance claim. Below are some reasons why your insurance claim can be denied.

22 Reasons Why Your Insurance Claim Can Be Denied/Rejected?

Among a large number of insurance claims, some amount of insurance claims can be denied because of different reasons.

Examples for insurance claim denied

  • life insurance claim
  • basement flooding insurance claim
  • fire insurance claim
  • health insurance claim
  • house fire insurance claim
  • other driver’s insurance claim
  • boat insurance claim
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So make your attention for below reason and try to prevent your insurance claim denied,

1.      Your premiums aren’t up to date or Unpaid. So try to pay your premium timeously and regularly or within the grace period.

2.      Unspecified or Unlicensed drivers drive your vehicle.

3.      Your vehicle is not in a roadworthy condition.

4.      Driving or using reckless or under the influence.

5.      No write-off cover, there will be no coverage for the cause of loss. so unless write-off cover is clearly stated in your insurance policy, your insurer will not be liable for claims.

6.      Tracking and security devices not fitted in your vehicle or devices.

7.      Property or vehicle using for another purpose. When you get insurance cover for personal use but if you use it to business purpose your claim will be denied.

8.      Not well maintain your vehicle or property

9.      In life insurance, the absence of nomination. Not mention nominated person or errors when nominating the beneficiary.

10.  Not providing accurate information or hide some information about yourself or your properties.

11.  Insufficient or limited coverage details.

12.  Obvious suicides or self-harm or addictions or HIV/AIDS

13.  Buying the wrong policy or choosing the wrong Insurance company

14.  Incorrect claim application or any other incorrect detail of your insurance coverage

15.  Delay of information about your damage to the insurer

16.  When a vehicle accident you move your vehicle for another place, without taking a photo.

17.  Not submission of FIR reports

18.  Settle with the third party without information to the police or insurer.

19.  Lost or not keep all the necessary documents with you.

20.  Insufficient proof submission for claiming your insurance claim

21.  Not update your policy

22.  Using for illegal activity

insurance claim denied what to do?

Because of one or more above reasons, your insurance claims can be denied. So it is better to know What To Do If Your Insurance Claim Is Denied?

01.Review your claim request

The review if you have to claim properly without any errors?

02.Review your insurance policy

Most of the time your insurance policy comes in writing, so you can review your insurance policy document. When your insurer denied your claim, first you need to review your insurance policy. With that, you can make an idea, What damages you have covered? What are your rights? And understand policy Maximus. 

With the above two steps, you can find out why your claim was denied? If you understand why your claim was denied, you can better determine whether it is worth appealing the decision? If you still feel your insurer decision was wrong, you can take further action?

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03.Gather details

If you feel it is possible before taking further actions you can get your claim, then gather the necessary pieces of evidence such as, facts regarding the incident (dates, involved parties), pictures of the damage, all documents related to insurance, evident that will show you are a responsible owner.

04.File an appeal

If not received any positive response for insurance claim denied Contact your insurance company and file an appeal. Do not afraid, you have the right to file an appeal. After you contact your insurer, they will provide the necessary details about filing an appeal. Also, you need to write a formal complaint letter.

How to write a formal complaint letter?

  • Follow the below tips to write your letter.
  • Put the date on the latter
  • Give your name & your policy number
  • Put the letter ‘complaint’ clearly at the top
  • Include any evidence you have to support your request
  • Say what you would like the company to do to put things right
  • Explain your complaint clearly
  • State that if you are unhappy with the company’s response you will take the matter to the next level or to the Ombudsman or court.

05. Get an independent assessment

If your problem is technical or specialist, it might be better to get an independent assessment. They will charge a small fee. You can send their report to the insurance company as evidence to prevent insurance claims denied.

06.Complain about insurance claim denied to senior staff in the insurance company

Kept all related your insurance and all the documenting you have from the claim process begun. Then, you can complain to the senior officer in the insurance company with your documentation, maybe they will offer some reasonable offer.

07. Go to the Ombudsman service

If you were unhappy with your insurance company’s complaints process, you have a right to take your complaint to the Financial Ombudsman Service about your insurance claim rejected. You can do this only after the received financial response from your insurer or after eight weeks have passed and you have not received any response from your insurer.

The Financial Ombudsman Service is an independent, free service that investigates complaints from individuals about insurance companies. They will consider both sides of the story, documentation and attempt to find a fair outcome based on the facts and common sense.

08. Complain your insurance claim denied to your state insurance department or board of insurance.

If you haven’t any positive response from the senior officer in the insurance company, you can complain about your problem with your state insurance department or board of insurance. In here very important thing is, you have to dispassionately present your side of the story, using the documents you have been taking.

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09. See and get help from a lawyer

If your re-claiming process against insurance claim denied was particularly bad, the courts will allow additional compensation when the insurance company acted in “bad faith”. This is the final way that you can claim your insurance claim. First, see a lawyer and explain your story and submit

Your documentation. Then, you can case a lawsuit against your insurance company.

10. Give up your try and say goodbye for your claim.

If your insurance claim was denied, you can follow the above steps to reclaim your insurance claim. If it is not successful remember that the final step gives up your try and says goodbye for your claim. Finally, I think now you have a better idea of why your insurance claim can be denied? What can you do if your insurance claim was denied/rejected?

Now, I think you have a better idea. What to do if your insurance claim is denied/rejected?

I hope the above Why and What To Do If Your Insurance Claim Is Denied? help you to make an idea about Reasons Why Your Insurance Claim Can Be Denied/Rejected? and What To Do If Your Insurance Claim Is Denied by your Insurer. And if you have any problem or know more about Why and What To Do If Your Insurance Claim Is Denied? Please share it with us in the comments section below. Thanks!

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21 thoughts on “What To Do If Your Insurance Claim Is Denied?”

  1. Thank you for giving us the valuable information about insurance….many people don’t know what he/she do if INSURANCE CLAIM IS DENIED.

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