How to Get Your Insurance Claim Paid

Filing an insurance claim can be confusing and overwhelming. Here’s how to navigate the process.

Close up of reading glasses on summary of claim
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Keep receipts for all out-of-pocket expenses such as a hotel stay while your home is being repaired or towing your car to a body shop following an accident.

[See: 10 Unexpected Costs of Driving.]

Here are your options if your claim is denied and you still believe it should be covered:

File an appeal. Once you've exhausted your insurer's internal channels for filing a claim, you can generally appeal with an external review through the government agency that oversees insurance companies in your state. "The insurance company is obligated to provide you with this information, but it might not be in the easiest-to-understand way," Rosen says.

In cases when an insurance company has denied coverage for a medical condition that's considered an emergency, you may be able to apply for an expedited review. Even if it's not an emergency, pay attention to timelines. "Don't ignore things because there are limits on how long you have to appeal [claims], and the clock is running," Rosen says.

Hire a professional. For smaller claims, it may not make financial sense to hire an attorney, advocate or public adjuster to help argue your case. But if large sums of money are at stake or the issue is complex, the math may pencil out. Depending on your state and the size of your claim, you may be able to hire a lawyer on a contingency basis, which means the lawyer "will only get paid if they recover for you, and their fee will be a percentage of what they recover for you," Bach says, adding that good contingency lawyers won't take on cases of less than $50,000 because their fee wouldn't be large enough to make it worth their while.

However, in many cases, consumers can recover losses on their own. "Insurance can be very intimidating," Bach says. "The lingo is confusing to the average person, but if you educate and empower yourself, you get a lot more than you think just by speaking up."