When you have medical, home or auto insurance, you have a well-founded sense of security, knowing there won\u2019t be any problems when you need it. Before the need arises, make sure you understand how to properly file a claim and receive the benefits to which you\u2019re entitled.<\/p>\n
The Claims Process \u2013 It\u2019s Not Rocket Science<\/strong> Know what’s actually covered<\/strong>:<\/p>\n Understanding what kind of homeowners insurance policy<\/a> you have can make a huge difference, when you file a claim. Picture this scenario: A meteorite crashes through the roof of your house and destroys your five-year-old television set. What happens when you file the claim depends on your policy:<\/p>\n Be aware<\/strong>: Flood damage is not covered under standard homeowners and renters insurance <\/a>policies \u2013 you must purchase separate flood coverage (available from the government’s National Flood Insurance Program and a few private insurers). Keep detailed documentation<\/strong>: Here are your options if your claim is denied and you still believe it should be covered:<\/strong><\/p>\n If your auto insurer denies your claim<\/strong> If your medical carrier denies your claim<\/strong> 2. Connect with patient advocates<\/strong>. 3. Resubmit your claim.<\/strong> 4. File everything electronically and keep records<\/strong> 5. Learn the price of the treatment that you were denied.<\/strong> More information about health insurance claims<\/strong><\/p>\n Your state insurance department has information about health insurance claim laws. Visit the National Association of Insurance Commissioners (NAIC) to access your state insurance department\u2019s web site via \u201cNAIC States & Jurisdictions\u201d at www.naic.org<\/a>.<\/p>\n
\nIf you neglect to provide an important document, your provider is out-of-network, or your damage is considered an excluded event, your insurance carrier may not cover your losses. So, what can you do to be sure you\u2019ll get paid on your claim?<\/p>\n\n
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\nAlso, most residential insurance policies do not cover earthquake damage \u2013 a separate earthquake policy is required.<\/p>\n
\nBack up your claim by maintaining thorough records of all forms of communications with your insurance company<\/a>. This can be invaluable if you need to appeal a decision.<\/p>\n\n
\nIf your claim is denied or the insurance company refuses to pay as much as they should, there are several things you can do:<\/p>\n\n
\n1. Identify why your claim was denied<\/strong>
\nIt may simply be a matter of some missing documentation.<\/p>\n
\nMany hospitals have social workers who help patients in dealing with healthcare insurance companies.<\/p>\n
\nInsurance companies use auditing software (claim review programs) which can be different between insurers. This means the chances of denial or approval are not written in stone.<\/p>\n
\nInsurance companies use electronic-claim-filing software to identify specific issues to quickly produce a valid claim and check insurance companies\u2019 denial formulas.<\/p>\n
\nIt\u2019s important to understand the reason for the denial. Usually, it\u2019s the price of the procedure. By knowing the price of the procedure and the amount your insurer will cover, you can negotiate how much of the difference you will pay.<\/p>\n