There’s a gut-sinking feeling when you make an insurance claim, and it gets denied. Suddenly, all of your hard work and money go down the drain. What could you have done differently to be granted your claim? Below we will outline seven common reasons for denied claims and what you can do to avoid them. Stay informed and stay ahead of the game so that you never have to experience the frustration of a denied insurance claim again.
Common Reasons for a Denied Insurance Claim
1. Lack of Proper Documentation
Make sure you keep all documentation related to your claim, including bills, receipts, medical records, and anything else that may be relevant. Your insurance company will need to see this documentation to process your claim.
If you don’t have proper documentation, your claim will likely be denied. To avoid this, always keep track of all documentation related to your claim. This includes receipts, medical records, timesheets, financial statements, timesheets, or anything else related to your claim. You can never be over-prepared!
2. Filing Too Late
You have a limited time to file an insurance claim, typically between 30 and 90 days after the incident occurred. If you wait too long to file, your claim will likely be denied.
This is why it’s important to act quickly after an incident occurs. As soon as you know you need to make a claim, start gathering the necessary documentation and contact your insurance company.
3. Making Incorrect or Incomplete Claims
You will be asked to fill out a form detailing the incident when making a claim. When filling out this form, it’s important to be as accurate and detailed as possible, as any incorrect or incomplete information may lead to a denied claim.
Be sure to double-check your form for any errors before submitting it to your insurance company. Be thorough with your review, and consider having someone you trust look over the information to ensure accuracy and completion. It may be wise to check your claim with a lawyer for advisement on how to fill out your claim for effective results.
4. Exceeding Your Coverage Limits
Every insurance policy has coverage limits, which is the maximum amount of money your insurer will pay out for a claim. If your claim exceeds your coverage limits, it will likely be denied.
To avoid this, make sure you are familiar with the coverage limits in your policy. If you think your claim may exceed your coverage limits, you may need to purchase additional coverage.
5. Making a Claim for Something That’s Not Covered
Most insurance policies exclude certain types of damages or incidents from coverage. If you try to claim something that’s not covered, it will likely be denied. To avoid this, familiarize yourself with the exclusions in your policy. This way, you’ll know what is and isn’t covered before you try to make a claim.
6. Pre-Existing Conditions
In some cases, insurance companies may deny claims for pre-existing conditions. These may include chronic medical conditions or lasting injuries, criminal histories, resident status, driving history, and more. Be upfront about any pre-existing conditions when you purchase your policy to avoid denied claims down the line. This way, you can be sure that you’re covered if you need to make a claim.
7. Making a Fraudulent Claim
Insurance fraud is a serious offense that can lead to denied claims, penalties, and even jail time. To avoid this, make sure all the information in your claim is accurate and truthful. Don’t try to exaggerate the extent of your damages or losses, as this will likely lead to a denied claim. Only make claims for damages or losses that you have incurred.
These are just some of the most common reasons for denied insurance claims. By familiarizing yourself with these reasons, you can avoid being denied a claim in the future.
If you do find yourself in a situation where your claim is denied, reach out to your insurance company to see what can be done. In some cases, you may be able to appeal the decision or provide additional information that could help get your denied insurance claim approved.