Question:
i just been denied now i need to write a appeal letter i need help

i meet the requirements that were stated in my insurance policy book but got denied because need to be on dr supervised diet for 1 year which was not stated in policy book i need a appeal letter please help!!!thanks    — dsrjrr (posted on March 22, 2004)

March 22, 2004
Is this your first denial? Also, if this is a new requirement made after you submitted your claim you might be able to get them on that. I was denied the first time because I didn't have Dr. supervised diet for 6 months. I fullfulled that obligation and then was denied because I didn't have a nutritionist involved. However, that requirement was new and wasn't in the original denial letter so I got approved on that technicality. So, when you initially filed and that wasn't a requirement perhaps you can get them to approve. Just a thought. Good Luck, Julie
   — Julie S.

March 22, 2004
I agree with the previous poster. You need to find out exactly when they added the additional requirements. Even though it wasn't in your policy book, it could have been added prior to your request, however, if it wasn't, you can fight it on those grounds. As for an appeal letter, I would just address each of your insurers requirements one by one and prove how you meet each of those requirements. Include copies of any medical records necessary to back up your letter. There isn't anything on your profile, and you don't mention who your insurance is so we can't be very specific in our help. Good Luck
   — Carolyn M.

March 22, 2004
Tina, I agree you should call the insurance company and find out when they added this "feature". Let me add, though, that you need to get something that is PRINTED with the date on it. Insurance ccompanies usually have a clause that says they can make changes at any time without notification, but if you can show that you submitted the letter before the diet requirement was added, you stand a good chance of being approved. Good luck!
   — koogy

March 22, 2004
Tina, I agree you should call the insurance company and find out when they added this "feature". Let me add, though, that you need to get something that is PRINTED with the date on it. Insurance ccompanies usually have a clause that says they can make changes at any time without notification, but if you can show that you submitted the letter before the diet requirement was added, you stand a good chance of being approved. Good luck!
   — koogy

March 23, 2004
Tina are you sure you never "told" your medical doctors about your previous attempts to lose weight. My insurer did not ask for specific dates and details - only what I "told" my doctor - and then my doctor wrote the letter indicating my attempts.
   — Anna M.