R&H Logo
Medical
Medical, Insurance Claim Denials
Attorney Matthew  Hamblin profile image
Matthew HamblinSenior Associate
Attorney Matthew  Hamblin profile image
Matthew HamblinSenior AssociateLitigation, Personal Injury & Car Accidents, Real Estate, Insurance Claim DenialsView profile
Limited appointments available
News & resources
Search Icon
FAQs

Under the Affordable Care Act (ACA), you have the right to appeal your health insurance company’s decision. You can start with an internal review of the decision. Your healthcare insurance provider conducts a review of its claim denial. If the denial stands, you can request a second internal review by a healthcare professional uninvolved in earlier decisions. You can attend this second review and even bring an attorney.

 If all internal appeals fail, you can request an external review by an independent entity. The Colorado Division of Insurance appoints this new reviewer. You and your insurer can challenge the final decision in court.

To prove bad faith, you must demonstrate that your insurer’s actions were unreasonable or that your insurer's investigation was insufficient.

If your claim is denied, request the reason in writing and continue to document all interactions. Keep a detailed log of all your communications with the insurance company.  

You can send a final written demand to your insurer. If you have an attorney, he or she can assist with this. 

If you're seeking for recourse beyond a large settlement offer, you can also file a complaint with the Colorado Division of Insurance.

Help circle iconHave a question?
Limited appointments available