Can I appeal an insurance denial?

Yes. Under the Affordable Care Act, most health plans must allow you to file an internal appeal and, if denied, request an external review by an independent reviewer. According to HealthCare.gov, you typically have up to 180 days to file an internal appeal.

Why was my insurance claim denied?

Common reasons include lack of medical necessity, missing documentation, prior authorization issues, or services not covered under your policy. According to the Kaiser Family Foundation, approximately 20% of in-network claims were denied under ACA marketplace plans in 2023.

How long do I have to appeal an insurance denial?

According to HealthCare.gov, many health plans require internal appeals within 180 days (about 6 months) from the denial notice. External review requests often must be filed within 4 months of the final internal denial decision.

What happens if my appeal is denied?

If your internal appeal is denied, you have the right to request an external review by an independent third party. According to healthcare industry research, 60-80% of external reviews result in the denial being overturned, especially for medical necessity disputes.

Does this tool provide legal advice?

No. InsuranceAppeal.ai provides educational guidance only and does not provide legal or medical advice. For complex cases, consult a patient advocate or healthcare attorney.

How to Appeal a Car Insurance Denial

Had your auto insurance claim denied? According to industry analysis, California, Texas, and Florida have the highest volumes of auto insurance claim disputes. This guide shows you how to fight back and get the compensation you deserve.

Key Statistics: Auto Insurance Denials (2024)

4,800 annual complaints — California leads in auto insurance disputes (Anidjar & Levine)
46% frustrated — Consumers report frustration with lengthy claims processes (LexisNexis)
10% rate increase — Auto insurance rates rose 10% in 2024 (LexisNexis 2025 Report)
93% would retain counsel again — Claimants who sought legal help were satisfied (LexisNexis)

Get Your Personalized Appeal Letter

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States With the Highest Auto Insurance Disputes

State	Annual Complaints	Key Issues
California	4,800	Claim denials, delayed payments
Texas	4,200	Claim handling, low settlements
Florida	3,800	Fraud issues, settlement delays
New York	3,500	High premiums, processing delays
Georgia	2,200	Coverage disputes, denials

Source: Anidjar & Levine analysis of state data

Why Auto Insurance Claims Get Denied

Lapsed Coverage

Missed premium payments or policy cancellation. Always verify your coverage is active before filing a claim.

Disputed Liability

Insurers deny claims when fault is unclear or disputed. Police reports and witness statements are crucial.

Policy Exclusions

Certain activities (racing, rideshare without endorsement, intentional damage) may be excluded from coverage.

Insufficient Coverage

Your policy may not cover the type of damage (e.g., liability-only doesn't cover your own vehicle damage).

Suspected Fraud

Insurers investigate claims that seem inconsistent. Maintain thorough documentation to avoid suspicion.

Step-by-Step: How to Appeal a Car Insurance Denial

Review the Denial Letter Carefully

The denial letter must state the specific reason. Common reasons include disputed liability, policy exclusions, or documentation issues. Understanding the exact reason determines your appeal strategy.

Gather Evidence

Collect police reports, photos of damage, witness statements, repair estimates from multiple shops, and any dashcam footage. According to Bankrate, independent estimates are crucial for negotiating fair settlements.

Get Independent Damage Assessments

Insurer estimates often lowball repair costs. Get estimates from independent body shops using OEM repair procedures. This provides leverage in negotiations.

Submit a Formal Written Appeal

Send your appeal via certified mail. Include all documentation, clearly address the denial reason, and reference your policy language. Keep copies of everything.

File a Complaint or Seek Legal Help

If your appeal is denied, file a complaint with your state Department of Insurance. For injury claims or high-value disputes, consult with an attorney. According to LexisNexis, 93% of claimants who sought legal counsel would use one again.

Sample Auto Insurance Appeal Letter

[Your Name] [Your Address] [City, State ZIP] [Date] [Insurance Company Name] [Claims Department] [Address] Re: Appeal of Auto Insurance Claim Denial Policy Number: [Policy Number] Claim Number: [Claim Number] Date of Accident: [Date] Dear Claims Manager: I am writing to formally appeal the denial of my auto insurance claim. Your letter dated [date] stated the claim was denied because [quote exact reason]. I believe this denial should be overturned because: 1. [Address the specific denial reason with evidence] 2. [Provide facts that counter the denial] 3. [Reference policy coverage that applies] I have enclosed the following supporting documentation: • Police report from [Date] • Photos of vehicle damage (timestamped) • Independent repair estimate from [Shop Name]: $[Amount] • Witness statement(s) • [Any additional evidence] According to my policy, [cite specific coverage language]. The damage from this covered incident should be paid. I request that you reconsider this claim and approve payment for repairs. Please respond within 30 days as required by [State] insurance regulations. Sincerely, [Your Name] [Phone Number] [Email Address]

Frequently Asked Questions: Auto Insurance Denials

Which states have the most auto insurance claim disputes?

According to industry analysis, California leads with 4,800 annual complaints, followed by Texas (4,200), Florida (3,800), New York (3,500), and Georgia (2,200).

Should I get a lawyer for my car insurance claim?

For injury claims, high-value damage, or disputed liability, legal representation often helps. According to LexisNexis,93% of claimants who sought legal counsel would retain services in future cases.

How do I dispute a low settlement offer?

Get independent repair estimates using OEM procedures. Document everything with photos. Submit a written counter-offer with your evidence. If they won't negotiate, file a complaint with your state insurance department.

Where do I file a complaint against my auto insurer?

File a complaint with your state Department of Insurance. Find your state's department at NAIC.org.

Ready to Appeal Your Auto Insurance Denial?

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Related Appeal Guides

Complete Insurance Appeal Guide

Step-by-step guide for all insurance types

Homeowners Insurance Appeals

Property damage and home claim denials

About This Guide

This guide is provided for educational purposes only and does not constitute legal advice. Statistics cited are from publicly available sources including LexisNexis, state insurance departments, and legal research firms.

For injury claims or complex disputes, consider consulting with an auto insurance attorney.