What to Do If Your Health Insurance Claim is Denied

How to handle getting your health insurance claim denied.

If you’ve ever had a health insurance claim denied, you know how stressful it can be. However, just because your insurer will not pay for your treatment or services doesn’t mean you need to rush to take out a loan or deplete your saving account. Take a look at these tips that can help you navigate the process of having your claim denied.

Find out why it was denied.

If your health insurance claim was denied, it’s a good idea to contact your insurance company to understand the reasoning behind the rejection. Common reasons include inaccurate information, missing details, treatment/services are not covered under your plan, or you waiting until the last minute to file a claim.

Seek assistance.

Once you know why your health insurance claim was denied, consider asking your doctor or hospital for help. They can potentially offer some support since they may have dealt with similar issues in the past. Additionally, consider talking to a hospital worker who may know an alternative way to get coverage for the treatment you need.


You have the right to appeal your insurer’s decision. Although the appeal process will vary from company to company and insurer to insurer, it could be worth contacting them to ask them to review their decision regarding your claim, especially if the treatment/service is typically covered under the policy. Keep in mind this process may take a while to reach a final decision.

Medical bills are expensive things that can put you in a hole if you don’t have the right health insurance policy at your side.  Visit the team at Lou Aggetta Insurance Services, serving Pleasant Hill and neighboring cities in California.