How can you negotiate a denied insurance claim?

2 Gather supporting documents

The next step is to gather supporting documents that can prove your claim is valid and reasonable. Depending on the type of insurance and the nature of your claim, these documents may include medical records, receipts, invoices, photos, videos, police reports, witness statements, expert opinions, or other relevant evidence. Organize your documents in a clear and logical way and make copies for your own records.

3 Write a demand letter

A demand letter is a formal document that outlines your claim, provides justification for it, and requests a specific amount of compensation. To be effective, it should be concise yet polite, professional, firm, and persuasive. The letter should include a summary of the facts and circumstances of your claim, a reference to the denial letter and the reason for disagreement, a breakdown of the damages and losses you suffered with an explanation of how they were calculated, relevant policy provisions, laws, or regulations that support your claim, a request for prompt resolution of your claim with a deadline for response and warning of further action if none is received.

4 Negotiate with the adjuster

Once you send your demand letter, you should expect to hear from the insurance adjuster, who is the person responsible for evaluating and settling your claim. The adjuster may call you, write to you, or invite you to a meeting to discuss your claim. Be prepared to negotiate with the adjuster and present your case confidently and respectfully. You should also be ready to compromise and consider reasonable counteroffers. However, don't accept the first offer or settle for less than you deserve. If you can't reach an agreement with the adjuster, you may need to escalate your appeal to a higher level or seek legal advice.

5 Know your rights and options

When negotiating a denied insurance claim, it's important to know your rights and options. Depending on the type of insurance and the jurisdiction, you may have different ways to challenge a denial or seek a review of your claim, such as filing a complaint with the state insurance department or regulator, requesting an independent or external review by a third-party organization or arbitrator, pursuing a mediation or alternative dispute resolution process, or filing a lawsuit against the insurance company in court. Each option has its own advantages, disadvantages, costs, and risks, so you should weigh them carefully and consult a qualified professional if necessary. Although it can be daunting and complex to negotiate a denied insurance claim, it's not impossible. By following these tips, you can increase your chances of getting a fair and favorable outcome. Don't forget that you have the right to challenge a denial and fight for what you're entitled to.

6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?