Health Insurance Center

Health Insurance Q & As

Question 2 of 6 in Collecting Claims, Dispute Resolution And Denials
My insurance company failed to authorized coverage and treatment. Is there anything I can do?
For starters. Check your policy or employee booklet for the company’s appeal procedures. Then phone and speak to a representative and ask why it rejected the claim. If still unsuccessful, contact your state’s insurance regulatory office for help. Usually a company will be more inclined to resolve a dispute after the state office jumps in on your behalf.

In some states, there is a procedure for "external review" of your dispute, which means an independent panel will review your case.