Denied Insurance Claims
Your Insurance Claim Was Denied, Now What?
Dealing with an insurance claim denial can be frustrating and overwhelming. Whether it’s health, homeowners, auto, life, or business insurance, you pay premiums expecting coverage when you need it. But what happens when your insurer denies your claim?
If you’re wondering, “What do I do if my insurance claim is denied?”, you’re not alone. Many policyholders face claim rejections, often due to misinterpretation of policy terms, missing paperwork, or bad faith tactics by insurance companies. The good news? You have options to appeal and fight back.
Why Was Your Insurance Claim Denied?
Before taking action, it’s crucial to understand why your claim was denied. Common reasons include:
Incomplete or missing documentation – Your insurer may require additional proof of loss, medical records, or receipts.
Policy exclusions – Some claims get rejected because they fall outside of what your policy covers.
Missed deadlines – Filing late or not responding to insurer requests can lead to a denial.
Disputed liability – In auto and home insurance cases, insurers may argue that another party is responsible.
Errors in your claim – Even minor mistakes in paperwork can result in a denial.
Bad faith insurance tactics – Some insurers deny valid claims to protect their bottom line.
What to Do Immediately After an Insurance Denial
If you received a denial letter, don’t panic—you still have options. Here’s what you should do next:
Review the Denial Letter Carefully
Your insurer must provide a written explanation of why your claim was denied. Look for the specific reason for the denial, any policy exclusions cited, or a deadline for appealing the decision.
Check Your Insurance Policy
Go through your policy to verify coverage details. Many insurers rely on complex wording to discourage claims. Understanding your coverage helps you dispute unfair denials.
Gather Evidence to Support Your Claim
Strengthen your appeal with documentation, including Photos/videos (for property damage claims), Doctor’s notes & medical records (for health or disability claims), Police reports (for auto or theft-related claims), and Repair estimates & invoices
Contact Your Insurance Company
Sometimes, a quick conversation can resolve the issue. Call your insurer, ask for clarification, and request a formal review. If an error caused the denial, they may reconsider.
File a Formal Appeal
Most insurers have an appeal process. Submit a written appeal letter that includes A clear request for reconsideration, A summary of why the denial is incorrect, and Supporting documents to strengthen your case
Contact Kane Advocates
If your appeal is denied or you suspect bad faith tactics, hiring an insurance claim lawyer like Kane Advocates can help. We specialize in challenging wrongful denials and negotiating fair settlements.
File a Complaint with Oklahoma's Insurance Department
If you believe your insurer is acting unfairly, you can file a complaint with your Oklahoma’s Department of Insurance. They may investigate and pressure the insurer to act in good faith.
Take Legal Action if Necessary
If all else fails, a lawsuit may be the only way to recover what you’re owed. Kane Advocates has decades of experience fighting for folks just like you. To start the process, just give us a call or send us an inquiry about your claim.
Types of Insurance Claims That Get Denied
Denials happen across all types of insurance. Here’s how they commonly play out:
Health Insurance – Claims for treatments, surgeries, or medications may be denied due to pre-existing conditions, out-of-network care, or insurer refusal to cover a procedure.
Homeowners Insurance – Water damage, roof claims, and theft claims are often rejected due to alleged negligence, lack of maintenance, or exclusions.
Auto Insurance – Insurers may deny accident claims by disputing liability or arguing damages were pre-existing.
Disability Insurance – Many disability claims get denied due to a lack of “sufficient” medical proof or an insurer claiming you can still work.
Life Insurance – Beneficiaries may face denials due to alleged misstatements on the policyholder’s application or policy lapse.
Business Insurance – Commercial property claims, business interruption claims, and liability claims can be rejected for vague reasons.
Fight Back Against Denied Claims
A denied insurance claim doesn’t mean the end of the road. Insurers count on policyholders giving up too soon—but you have rights and options. By understanding why your claim was denied, gathering strong evidence, and pushing back through appeals or legal action, you increase your chances of getting the coverage you deserve.
If you’re struggling with an insurance denial and need expert help, don’t wait. Take action today and fight for the payout you’re entitled to!