I received a letter from my insurance company stating that I need to respond, or my doctor’s visit will be denied. A few days ago, I experienced significant pain in my arm (rated 6 or 7 on the pain scale) after assembling my home gym. Since the pain didn’t subside after several hours and my primary care physician was unavailable on Saturday, I decided to go to urgent care just to be safe. They diagnosed me with a sprained elbow.
Now, my insurance is asking for more information about the injury, including details on where it occurred, whether I own my home, and if it was related to a car or boating accident, among other things.
I’m concerned that they might deny my claim for what I believe to be a routine medical issue, and I’m unsure how to properly fill out their questionnaire.
Any suggestions on how to handle this?
It’s understandable to feel anxious about responding to your insurance company’s inquiries, especially when it relates to a recent injury. Here are some steps you can take:
Read the Letter Carefully: Make sure you fully understand what information they are requesting. Sometimes these inquiries are standard procedures for determining coverage.
Be Honest and Clear: Answer all questions truthfully based on your situation. Explain that the injury occurred while setting up your home gym, and clarify that it was accidental and not related to any automotive or boating incident.
Provide Context: If possible, include a brief note explaining the circumstances of the injury, highlighting that you sought care promptly because of the severity of the pain.
Document Everything: Keep a copy of your response and any supporting documents (like the visit record from urgent care) that may help clarify the situation.
Contact Your Insurance Company: If you’re still uncertain about how to answer certain questions, consider calling their customer service for clarification. They can guide you on what information is needed.
Follow Up: After you send your response, keep an eye out for any further communication from your insurance company, and be proactive in following up if you don’t hear back in a reasonable timeframe.
By being thorough and clear in your response, you increase the chances of your claim being approved. Good luck!