- You are ill from the previous illnesses (like asthma, or previous heart failures) but you never inform your insurance company
- The claims are not covered within the insurance policy that you purchased
- You did not provide sufficient information to apply a claim
- Many other factors
If the insurance company disapproves your claims, the first thing to do is to stay calm. That would most likely be difficult, since most of us will actually bombard the insurance company with plenty of protests. Such protest actions will end up in vain because the insurance company has a legal representative to defend itself. The best effort is to search for a win-win solution for both parties.
Once you have calmed down, you can ask the clear explanation why your claim was disapproved. When the reasons have been told, but you still insist that your claim is valid, you can apply a recourse for the disapproved claims. Provide all the required documents (such as your doctor’s recommendation) to support your claims’ validity, that the insurance company have to pay for the claim. Also highlight the benefits you should be receiving from the insurance policy which you bought. Pay attention to the designated time because some policies include time limits on which you can recourse your claims.
Every time you’re having a discussion with insurance officers, make written notes of date and time, the corresponding officer’s name, and the points of your discussion. If your claims are still disapproved, you can take a recourse to the higher ups with higher authorities in that company.
You can also attempt arbitrations, by filing in your complaints to the State Insurance Commission (SIC). The last action is through legal suits, but bewares. This is the path you should reserve until every other actions have failed to persuade the company in approving your claims.
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