[date] [recipient name] [recipient address] Re: Formal Appeal of Denied Claim #[claim number], Policy #[policy number] — $[amount disputed] in Dispute Dear Appeals Department: I am formally appealing your denial of the above claim. Your stated reason — "[denial reason]" — is not supported by my policy terms or the facts of this claim. Facts: [facts] Requested resolution: [desired outcome] Please treat this as a formal appeal under my policy's internal appeal process and applicable law, including ERISA where my coverage is employer-sponsored, and my state's unfair claims settlement practices act and bad-faith statutes. I request a written determination within the timeframe required by law, along with the complete claim file and the specific policy provisions relied upon for denial. If this claim is not resolved fairly, I am prepared to file a complaint with the state insurance commissioner and to pursue a bad-faith claim. Sincerely, [user full name] [user address]
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Insurance Denial Appeal
Push back on a wrongfully denied insurance claim with statutory teeth.
Answer a few plain-English questions and we'll generate a professional letter addressed to your insurance company — citing the right rules, in the right tone, ready to send. No account needed to start.
- Cites ERISA appeal rights and state bad-faith insurance statutes
- Insurers must issue a written determination within a statutory window
- 68% of first-level appeals result in a changed outcome or settlement offer
STEP 1
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A short guided form — about 3 minutes.
STEP 2
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STEP 3
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Insurance Denial Appeal
Question 1 of 1010%
The person, company, or agency this letter is addressed to.
✓ Cites ERISA appeal rights and state bad-faith insurance statutes
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This is your live draft. When you finish the questions, our AI rewrites it into a polished, statute-cited letter — then you create a free account to save and download it.Your first letter is free. No credit card.
Frequently asked
- How long does the insurer have to answer?
- Internal appeals generally must be decided within 30 days for pre-service claims and 60 days for post-service claims; urgent care appeals are typically 72 hours.
- What if the internal appeal fails?
- You can request an external review by an independent reviewer. Your written appeal is the record that external reviewer will read.
- Should I mention bad faith?
- The letter references your state's unfair claims settlement practices act, which signals you know the insurer's obligations without threatening anything you can't back up.
- Does this replace a formal insurance appeal?
- It is the formal appeal. The letter is structured to meet most insurer and hospital appeal requirements, including the basis for your dispute.
- Do I need an account to start?
- No. You can fill out the form and generate a draft for free. You only pay when you want to unlock and download the final letter.
- How much does it cost?
- Downloading a letter is a flat $2 — any dispute type. Want it sent for you? $8 covers printing and USPS Certified Mail with tracking. Subscription plans are also available if you expect to send several letters.
- Will this letter actually work?
- A well-written, specific letter — citing the right rules and a clear desired outcome — dramatically increases your odds. We can't guarantee any particular result, but a real letter beats silence every time.