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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.