Guide to understanding and filing health insurance claims. Covers reading EOBs, appealing denied claims, and navigating pre-authorization.
Insurance Claims Guides
Filing an insurance claim can feel overwhelming, especially during a stressful situation. These step-by-step guides walk you through the claims process for different insurance types, with documentation checklists and timeline expectations.
Claims Guides by Type
Auto Insurance Claims
What to do after a car accident, how to document the scene, and working with your insurer. Covers collision claims, comprehensive claims, and dealing with the other driver’s insurance.
Home Insurance Claims
Filing claims for property damage, theft, and liability incidents. Includes documentation tips, working with adjusters, and getting fair repair estimates.
Health Insurance Claims
Understanding EOBs, appealing denied claims, and navigating the pre-authorization process. Covers both in-network and out-of-network situations.
General Claims Tips
Before you need to file a claim:
- Know your policy - Understand your deductibles, coverage limits, and exclusions
- Document your property - Keep a home inventory with photos and receipts
- Save your policy documents - Keep digital copies accessible
- Know your insurer’s claims number - Add it to your phone contacts
When you need to file:
- Act quickly - Report incidents promptly
- Document everything - Photos, receipts, police reports, witness info
- Keep records - Note dates, times, and names of everyone you speak with
- Don’t accept the first offer - You can negotiate if the settlement seems low
Related Resources
- Insurance FAQ - Common questions about claims and coverage
- Insurance Glossary - Terms you’ll encounter during the claims process
Frequently Asked Questions
How long do I have to file an insurance claim?
Most policies require prompt notification, typically within 24-72 hours for auto accidents and property damage. Health insurance claims usually have 90 days to a year depending on the insurer. Check your policy for specific deadlines—delays can result in claim denial.
What happens after I file a claim?
After filing, an adjuster is assigned to investigate your claim. They’ll review documentation, may inspect damage or interview witnesses, and determine coverage and payout. This typically takes 30-45 days for straightforward claims, longer for complex ones.
Will filing a claim raise my insurance rates?
It depends on the claim type and your history. At-fault auto accidents typically raise rates. Not-at-fault accidents and comprehensive claims (weather, theft) often don’t. Frequent claims of any type may increase rates. Many insurers offer accident forgiveness for your first claim.
What if my insurance claim is denied?
You have options: request the denial reason in writing, review your policy terms, file an internal appeal, contact your state insurance department, or consult an attorney for large claims. Many denials are reversed on appeal when proper documentation is provided.
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