Personal Advantage
January  31, 1992

By William M. Shernoff

How to Challenge an Insurance Company that Refuses Your Legitimate Claim

About 10% of all insurance claims are unjustly denied. But fewer than 1% of people making insurance claims even question their insurer when their claim is refused. Insurance companies routinely maximize their profits based on the expectation that policyholders will passively accept their decisions. Result: Millions of small, honest claims are denied and never challenged.

Important: The majority of policyholders who do contest denied claims either win their cases or improve their settlements.

Steps to take when faced with an insurance ruling you believe to be unfair:

Don't assume that the first "no" you receive is final. Insurers often change their rulings when challenged.

Insist on a written explanation. Most state laws require insurance companies to provide written explanations of claims denials. Failure to comply may constitute an illegal practice by the insurer.