Insurance claims: How to settle a claim and resolve a dispute

It might happen that your insurance company doesn’t pay for the coverage even if you purchase adequate insurance and pay your premiums on time. In most cases, you’ll be able to settle your insurance claims disputes if you know the right way to do it.

How to resolve a claim dispute

Follow these steps to resolve your insurance claims disputes.

1. Collect required documents: Apart from the policy documents, you also require the written document through which your insurance company has denied your claim.
2. Go through your policy documents: Read your policy documents and find out the services excluded from your specific policy. Make a note of those sections that are relevant to your situation.
3. Contact your insurance company: Contact your claim adjuster and explain why you think your claim was denied by mistake. Make sure you ask a date within which your claim will get resolved. Do not forget to call them back on the mentioned date if your claim is not resolved by then.
4. Document your efforts for future referral: Keep all your documents for future referral. Make sure you get the name of the claim adjuster you speak with; it’ll help you to follow up.

Don’t give up while resolving your claim. If the claim is not resolved within the due date, then you should contact the insurance department of your state in order to file an appeal. In most cases, the dispute gets resolved with state insurance department’s intervention.

4 Tips to settle your insurance claims

Here are 4 tips that’ll help you to settle your insurance claims.

Insist on a written explanation: Most state laws require written explanation of claim denials. Therefore, insist that your insurance company provides you with a written clarification of your claim denial.
1. Be careful of filing errors: Make sure you follow the instructions while filling out your insurance claim form; if required, take professional help. However, filing errors cannot be an excuse for a claim dispute unless it’s a valid one. As for example, if your error delays an adequate investigation.
2. Make a written complaint: At first, communicate with the person who denied your insurance claim. If the matter is not resolved, then make a written complaint to his/her supervisor along with the necessary documents. Send all your letters by registered mail and keep copies of all your correspondence.
3. Contact your insurance agent: It is your insurance agent’s duty to see that you get the right coverage. Therefore, contact your agent, explain your situation and ask him/her to help you out.

It is quite necessary to send follow-up letters if your dispute does not get resolved within the stipulated time, as mentioned by your insurance company. You should also attach all the correspondence documents of your insurance claims and send the letter to the customer service department and to the company president. Most states treat it as an unfair practice if you don’t get a prompt response.

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