insurance denial
Claim gets rejected
Insurance denial is the rejection of a claim by an insurance company, declining to cover or pay for a service, treatment, or loss.
In healthcare contexts, denials often cite lack of medical necessity or policy exclusions: The insurance denial meant she had to pay for the surgery out of pocket.
Policyholders can typically appeal denials through formal review processes.
- claimStatement of ownership or truth
- claim formDocument requesting payment owed
- rejectedRefused or turned away
- prior authorizationInsurer's advance approval requirement
- appealFormal review request
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- hardshiphardship, adversity, difficulty, trouble, struggle
- rejectionsno, rejection letter, refusal, decline, turndown
- financial biasredlining, fair lending, interest rates, loan rates, approval rates
- ableismableism, stigma, prejudice, discrimination, exclusion
insurance denialinsurance approval
Confirmation of coverage eligibility
reimbursement · payout · settlement · approval · authorization
insurance denialfull coverage
Protection without exclusions
blanket coverage · comprehensive coverage · pre-authorization · prior approval
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