Insurance denial appeal

Sometimes, insurance companies play hardball and don’t want you to have something you should easily have access to, which is health insurance. In the case that you might need to write an insurance denial appeal letter, you should be clear, state your objective reasoning and any evidence you have. Insurance companies can be tough to reason with or to persuade but with some effort and a well-worded letter, you might just get the insurance you need.

Steps

Starting to Write

1

Come right out and state that the letter is for the purpose of appealing a denial.

2

State who the insurance would be for and why you would like it appealed.

3

If there any conflicts of past issues that need to be mentioned, feel free to state them.

4

Ask them again to re-consider the claim to and to contact you for further information.

Sample Letters

Sample Insurance denial appeal


Dear Insurance Agent,

I am kindly asking that you reconsider the denial to pay for my Daughter Haley’s Retina prescription. Not only is this denial baffling to me but in the past, our insurance policy has covered the medicine, so this makes no sense as to why it’s being denied this time.

Our family Dermatologist Dr. Hunter has prescribed this exact medicine three times now and the first two times never raised any questions. Also, if you will note that we submitted this form to you last month for reimbursement but have yet to hear back anything other than a rejection letter which makes no sense.

I have enclosed the doctor’s statement in this letter and the verification form for the medicine. I would ask that you please re-consider the claim or at least give me a reason as to why the claim is being denied now after two years.

I may be reached at 122-262-1837.

Thank you for your prompt response and action.

Sincerely,

Adam Marshall