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How to Appeal Against a Denied Health Insurance Claim in Dubai

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How to Appeal Against a Denied Health Insurance Claim in Dubai

Health

Published on 10 Jan 2019

Last updated 08 Oct 2022

4 min read

You’ve been feeling confident up to now. After all, you have health insurance in Dubai and access to state-of-the-art medical facilities. Then comes the shocker – your medical insurance claim has been denied. Although it’s impossible not to be worried in such a situation, don’t despair. Undertake an appeals process with your insurer to see if you can rectify the matter.

Know Why Your Claim Was Turned Down

Before you can appeal effectively, you need to know the precise reason why your claim wasn’t accepted. Your insurer should have provided this information, but if you are unsure of the terminology or want a more detailed explanation, call the insurance company or your broker for assistance.

Look for the Little Things

Medical insurance claims can sometimes be turned down because of simple little things like your doctor misspelling your name, or a mistake made when filling out the claim form. Look carefully for errors or discrepancies, especially if you’ve been informed that incorrect or incomplete information are the cause of your claim having been denied.

Have Evidence of Medical Necessity

You should have a full record of all the treatments you received. Your doctor can help you with interpreting your health insurance plan’s medical policy for the type of treatment you needed. Your doctor can also help with medical history information that could mean your claim is accepted the second time around.

Be Well-Organized

You don’t want to start at square one every time you talk to your insurance company or broker. Keep all correspondence and documentation in one place so that you can quickly reference information. Write down the name and designation of any insurance company the employees you speak to and always ask for reference numbers after calls. Some brokerages also offer a dedicated claims manager who would be your main point of contact throughout the claims process.

Follow Up

Once you have re-submitted your claim, don’t just forget about it. Ask about the turnaround processing times and follow up if you do not hear from your insurer on the specified date. A gentle reminder could be all it takes to get your appeal moving forward.

Keep it Courteous

Having a medical claim denied is very stressful, but venting at insurance companies’ employees or even your broker will not advance your cause. If you purchased through an insurance broker, feel free to tell them that you are worried and upset, as chances are, they will try to help you through the appeals process. Getting this insider help means maintaining a friendly and courteous relationship with company representatives.

Ask Your Doctor for Help

If you are currently very ill, dealing with the medical insurance appeals process could be more than you can manage. Talk to your doctor about your situation. He or she may be able to help you with the claims process. Medical insurance in Dubai is on par with the best the world has to offer, and if your claim has been turned down, there’s a good chance you can still get it accepted by following the appeals process.

Health Insurance Cover

Choosing Medical Insurance in Dubai

Naturally, you can’t claim if you aren’t covered, and different medical insurance plans offer different benefits. Don’t wait until you get tangled up in the claims process only to find that you aren’t covered. Choose a medical insurance plan that’s customized to meet your needs. Let us help you.

 

author

ABOUT AUTHOR

With over 34 years in the international insurance industry in a variety of senior management roles, and as holder of the Diploma in Insurance from the Chartered Insurance Institute, Rachel surely knows her insurance! With experience in London, continental Europe and the Middle East, Rachel is here to share her knowledge and help you understand more about insurance products in this easy-to-understand series of videos and blogs.

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