How To Deal With Declined Insurance Claims

By Greg Dobrin    September 11, 2017


Have you ever had a declined insurance claim? When things are handled badly, it can be a pretty frustrating experience for all involved.

In this Advisr Experts Opinion, Greg Dobrin, of Sureserve Financial Services, discusses the actions you can take to deal with declined claims.

Dealing with the insurance industry has its ups and downs.

Sometimes a claims are straightforward and a breeze to run through. Other times, insurance claims are declined for reasons you were never aware of. You’re probably reading this because you are or have thought about “How to Deal with Declined Claims”. Read on to find out!

Every insurer has a different approach and philosophy regarding the treatment of claims. As a result, this affects the customer’s experience with each individual insurer.

Likewise, claims assessors often have different approaches to the same issue. Medical practitioners who provide information about claims may also have a different point of view regarding the same issue. This is to say that every insurer deals with claims differently and these differences should be expected when lodging for one.

In addition, claims can take a while to finalise and this can be due to a few reasons. The variety of factors to be considered that may impact the time taken in processing claims. 

For example, some of the reasons for complexity of each claim is that all claims have differences:

  • For each claim the insured person is always different.
  • The circumstances of the incident is usually different.
  • As such, there are many grounds for review when a claim is denied in the first instance.

If it occurs, the declined insurance claim is not the end of the matter. Each insurer has a mechanism to undertake a review of a declined insurance claim, and the insurance industry itself has more formal process for review. Think of it as an appeal like the court systems if you do not think justice has been dealt. If circumstances become dire, litigation (often as a last resort) is also an option.

So whilst having a denied insurance claim can be a frustrating experience, there are still other options for you to consider. So, now that the tables have turned, take advantage of this newfound knowledge and stay in control of your claim.

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