How to File a Complaint Against an Insurance Company That Isn’t Responding to Claims

In the wake of a recent post, we’re going to explore the topic of what to do when your insurance company is not responding to claims. While the specific post dealt with a secondary health insurance provider, the principles apply to all types of insurance. If you’re facing a similar situation, it’s important to know that you have options.

Understanding the Claims Process

When you file a claim, you’re essentially asking your insurance company to pay for a covered loss. The claims process involves several steps:

1. Submitting the claim: You can submit a claim online, by mail, or over the phone.

2. Processing the claim: The insurance company will review your claim to determine if it’s covered under your policy. They may request additional documentation or information.

3. Making a decision: The insurance company will make a decision on your claim and send you a letter explaining the outcome.

4. Receiving payment: If your claim is approved, you’ll receive payment from the insurance company.

What to Do If Your Insurance Company Isn’t Responding

If you’ve filed a claim and haven’t heard back from your insurance company within a reasonable amount of time, there are a few things you can do:

1. Contact your insurance company: Call or write to your insurance company to inquire about the status of your claim. Be sure to have your policy number and claim number on hand.

2. File a complaint: If you’re not satisfied with the response you receive from your insurance company, you can file a complaint with your state’s insurance department.

3. Seek legal help: If you’ve exhausted all other options and still haven’t received a response from your insurance company, you may want to consider seeking legal help.

How to File a Complaint

The process for filing a complaint against an insurance company varies from state to state. In general, you’ll need to:

1. Contact your state’s insurance department: You can find the contact information for your state’s insurance department on the National Association of Insurance Commissioners website.

2. File a complaint: You can file a complaint online, by mail, or in person.

3. Provide documentation: Include a copy of your insurance policy, your claim form, and any correspondence you’ve had with the insurance company.

4. Follow up: The insurance department will investigate your complaint and let you know the outcome.

Additional Tips

Here are a few additional tips for dealing with an unresponsive insurance company:

Keep a record of all communication: Document all phone calls, emails, and letters you have with the insurance company.

Be persistent: Don’t give up if you don’t get a response right away. Keep following up until you get a resolution.

Don’t be afraid to escalate the situation: If you’re not getting anywhere with the insurance company, don’t hesitate to contact your state’s insurance department.

Filing a claim with your insurance company should be a straightforward process. However, if you’re not getting the response you deserve, don’t hesitate to take action. By following the steps outlined above, you can help ensure that your claim is processed fairly and that you receive the benefits you’re entitled to.