Guides: appealing insurance denials
Short, sourced guides. Start with the first-steps checklist.
Health insurance denial: first steps
A calm checklist for the first week after a health insurance denial: read the notice, find the deadline, call, ask for the file, and appeal in writing.
How to read a health insurance denial letter
What to look for in a denial notice or explanation of benefits: the reason, codes, criteria, deadlines and appeal address.
ERISA vs state-regulated health plans: why it matters
Self-funded employer plans, insured employer plans, individual plans and government plans have different referees. Here is how to tell which you have.
How to file a health insurance internal appeal
Step-by-step: gather documents, answer the stated reason, ask your doctor for a targeted letter, and file with proof.
Independent external review: how it works
What external review is, which denials qualify, the 4-month filing window, timelines, cost and how to ask.
State insurance department complaints: what they can and cannot do
How to file a complaint with your state insurance department, what to include, and honest limits on what regulators can do.
Prior authorization denied: what to do
If your plan denied approval before care: ask who is appealing, request a peer-to-peer review, and know the pre-service appeal timelines.
Medicare and Medicaid appeal basics
Short pointers on appeal windows for Original Medicare, Medicare Advantage and Medicaid managed care, with links to official pages.
Disability insurance denied: appeal deadlines and the lawsuit trap
Employer long-term disability appeals under ERISA: 180 days, decision times, getting your file, and why the plan's own time limit for suing can be shorter than expected.
Homeowners or renters claim denied or underpaid
A practical order of steps for property claim disputes: policy sections, written reconsideration, state complaint, and the deadline you should not miss.
Auto insurance claim denied or disputed
When your own auto insurer denies, delays or lowballs a claim: ask in writing, use the policy, escalate to the state insurance department.
Travel insurance claim denied
What to gather and how to appeal a denied trip cancellation, interruption or medical claim, including state escalation.
Surprise bills and billing errors: where to start
A short pointer page: ask for an itemized bill, check the EOB, and use the federal No Surprises Help Desk.
Mental health or substance use care denied: parity and appeals
What the federal parity rules say, red flags the Department of Labor lists, how to ask for the plan's rules, and the appeal steps for a denied mental health or substance use claim.
Prescription drug denied or not covered: exceptions and appeals
How a drug exception request works, what your doctor has to confirm, Part D decision times, and how appeals and external review follow a "no."