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Insurance Claims Get Rejected

ic-3It’s hard to determine just how many homeowners’ insurance claims get rejected because companies keep the information secret. The usual estimate of the number rejected is around 5% and it’s estimated that half of those claims are wrongfully denied.

The insurance industry has gained a negative reputation for denying claims for health care, especially for customers who are stricken with serious disease and infections, including cancer.

A new Vermont law requires insurers to disclose rejection rates. The law was imposed just last year, and it found that Cigma denied a whopping 21% of claims made by its customers and MCP denied 15.5%. Blue Cross rejected 7.6%.

Claims can be rejected for a wide variety of reasons. Sometimes the rejection is caused by an error on the part of the person filing the claim or the insurer. Any error on the claim or in the filing process can cause it to be rejected. There are also some situations in which claims are more likely to be rejected.

Claims are often rejected after a major catastrophe because the sheer volume of claims filed, leading to more mistakes.

Slash Your Home Insurance Premiums. Search for Lower Rates Big reasons for rejections include lack of evidence, improper filing and failure to follow the process. Most of these causes can be blamed on plain old fashioned human errors.

How to Avoid Having your Claim Rejected

There are several steps you can take to lessen the possibility that your claim might be rejected. Some of these steps include:
• Take your time and wait to file. Many people file right after a catastrophe or loss. That means they are often upset, angry, frustrated and more prone to make mistakes. If it is possible, wait for a few days to file.

• Don’t send in the claim as soon you prepare it. Set it aside and take a second look the following day before you file it. You’ll be more likely to spot mistakes when you take a second look.

• Have somebody else look over the claim before you file it and ask them to look for errors. Even if it’s your brother, another person might spot a mistake that you missed.

• File online. Type writing is easier to read and less susceptible to mistakes than hand writing. Before filing online read the form carefully and if necessary print it out and read it before filing.

• Have proof of your claims for easy access. A great method is to take digital photos of your home or lost valuables and put them in a cloud storage solution like Dropbox. That way you can simply download the photos then file with them with the claim online.

What to do if a Claim is Rejected

The first step you should take when a claim is rejected is to ask why. If the documentation the insurer provides doesn’t give a good reason call and ask why it was rejected. Try asking others such as your insurance agent to call and ask why it was rejected.

The next step to take is to re-file the rejected claim. Remember insurance adjustors and executives are human beings and no two of them are the same. That means a claim that was rejected last week for a surgical procedure might be accepted this week because somebody else read it.

Finally, be willing to complain if a claim is rejected. Insurance companies want your business and your premiums. In many cases they’ll review claim rejections and change the decision if a person complains. Claim rejections can be tough but there are ways to get around them.