My medical insurance company refuses to pay a claim it approved, what should I do?

Answer by  RobertB (111)

Carefully document your claim and all supporting materials and send the documentation to the insurance company, your medical provider, and your employer (if applicable).

Answer by  Avidiva (82)

If you have filed a claim that has been approved, the insurance company should not be refusing to pay. You should contact the insurance commisioner in your state and file a complaint. Be sure to keep all your paperwork and correspondence from the insurance company.

Answer by  tamarawilhite (17883)

First, find the documentation that shows they approved it. Then send a copy of that in with the bill for them to pay.

Answer by  roguecopycat (62)

You need to get a copy of your actual policy, it will outline the steps you need to take to settle a dispute with your insurance carrier, most require some form of mediation.

Answer by  caporfirio (804)

You first step would be to call them one last time. When you call the company let them know that if action is not taken in a timely manner that you will be contacting a attorney. If that doesn't "get the ball rolling" I would contact a local attorney and see what they have to say.

Answer by  Rubberchicken (819)

Follow the appeal procedures on the explanation of benefits that was sent to you advising of the denial. This will give you the best chance to have your case revisited.