Beware the Internal Insurance Company “Appeal”

After denying your insurance claim for critical illness, commercial insurance or disability insurance, the insurance company will often say that you can “appeal” their decision to deny your claim internally to a higher level “manager”, “review officer,” “internal tribunal” or “committee”—all employees of the insurance company. 

Please note that such a process is not a substitute for a lawsuit. 

Often such a process will prolong the processing of your claim and may even put your entire claim in danger should you decide not to sue in court while waiting for the outcome of the internal “appeal” or “review.” 

There are very strict limitation periods that must be observed. While wasting time on your appeal, you might decide to delay seeing a lawyer or starting a lawsuit. That delay could cost you your entire claim as if you miss a limitation period (usually two years but sometimes a matter of months), your entire insurance claim will be lost. Please note that only a lawsuit will secure your claim against the passage of a limitation date.   

The other risk is that you may make oral or written statements during the “review process” that the insurance company could use against you at a later time during a lawsuit as an excuse to deny your claim or attempt to attack your credibility. 

In addition, keep in mind that the person or tribunal you are appealing to consists of employees of the very same insurance company. Therefore, such an “appeal” is to an authority that is in a conflict of interest with you. It’s not an impartial tribunal and the results, not surprisingly, are usually a confirmation of the denial by the original claims adjuster. 

Instead of getting caught up dealing on your own with an insurance company putting up roadblocks to acceptance to your claim, phone Dyson Law for a consultation regarding your denied life, critical illness, disability or commercial insurance policy. 

Contingency fees (no win, no fee) are available.