Denied Insurance Claims
You can submit a claim to cover your damages after a destructive event that results in severe damages to your home and property. However, in some instances, your claim can be denied for various reasons. In the unfortunate circumstance that your claim was denied, you can get representation from a legal professional who can fight for your right to receive coverage for your damages. To get maximum compensation, call the Florida Home Claim team to get a free consultation in Florida.
Which is an example of a denied claim?
Denied claims occur when the claim is received and processed, but then denied for some reason. The claim will then be considered unpayable and a closed case. Denied claims cannot be resubmitted and will have to be redone before submitting it again. The reason for a denied claim is often because of vital errors. The rejected claim should include an explanation of any errors detected so that they can be corrected.
Why do claims get denied?
Insurance claims can have a simple issue that can be corrected, or they can be denied over a dispute of liability or fault.
Sometimes the information you provide is inaccurate or incomplete. There may be missing data, such as not listing all the damages that occurred or a lack of reliable proof. The dates of the event that caused the damages may be incorrect, or other necessary details.
Didn’t Seek Medical Attention
If you didn’t get help from a doctor after your injury and have no record of your physical damages, then this may be the reason your claim was rejected. You should always see a doctor immediately after you’ve been injured.
A rejected claim can also be due to a coding error. If a mismatched procedural code doesn’t reflect what is covered by your policy, it can be rejected.
Sometimes, your submitted claim is not covered by your specific insurance policy. This confusion can be explained by the insurer, but if you believe they are being unfair, you can speak to a legal representative to review your claim.
You Were Partially At Fault or Liable
If you were the cause of your damages, your coverage may be voided under your insurance policy. For example, if you were intoxicated and set fire to your home, your insurer won’t cover the damages.
What is the difference between a rejected claim and a denied claim?
Claim rejection happens before a claim can even be processed. This is often due to the incorrect data being filled out on the claim. The insurer will reject the claim before it is even looked at. A denied claim occurs when the claim has been processed, then the insurer decides that it is unpayable. This can be due to policy coverage limitations or for other reasons. A rejected claim can simply be resubmitted with updated information; this way, it can be correctly processed. A denied claim can’t be resubmitted, and you will have to appeal to the insurer and prove that you deserve coverage.
How do you handle a denied claim?
After your claim has been denied, you should carefully reread all of the notes on your claim and any explanations that define why it was denied. This way, you know exactly why your claim was denied. You can stay in contact with your insurer and keep communication continuous regarding the status of your claim. Don’t delay the process and act quickly. You should try to understand your insurer’s appeals process to help you avoid common errors and so that your coverage can be provided much more smoothly. Your insurer can provide their own explanation, but if this isn’t sufficient, you can reach out to an attorney who can review your case. They can help determine if the policy should cover your damages because they understand insurance jargon and regulations. If they deem that the denial was unfair, they can help represent your case to help you obtain fair compensation.
After my claim has been denied, how do I begin?
When your claim has been denied, you should immediately read any communication from your insurer regarding your claim. Once you understand why your claim is denied and identify whether you inputted any errors, you can then start the appeals process. If the appeals process doesn’t work in your case, you can contact an attorney to help you obtain the compensation you deserve. They can review the events that caused your damages and calculate the amount you are due, then contact your insurer on your behalf. Call Florida Home Claim to learn more information.