Can I fight an insurance denial without a lawyer?
Yes — most denials are reversible without an attorney. Here's how.
The vast majority of insurance denial appeals are handled without an attorney. Federal law (ERISA §503 + ACA §2719) gives you the right to appeal, the right to documents the plan relied on, and the right to external review by an Independent Review Organization whose decision binds the plan. You don't need an attorney for any of this.
Steps
- Read the denial letter carefully — find the specific reason
- Request the plan's specific criteria they relied on (you have this right)
- Gather supporting documentation — chart notes, specialty-society guideline citations
- File a written appeal within 180 days (federal floor)
- If denied, request external review by IRO
- Free resources: DenialHelp drafts the letter in 5 min; your state's ACA Consumer Assistance Program offers free help; your state insurance department handles complaints
Frequently asked questions
Can I fight an insurance denial without a lawyer?
The vast majority of insurance denial appeals are handled without an attorney. Federal law (ERISA §503 + ACA §2719) gives you the right to appeal, the right to documents the plan relied on, and the right to external review by an Independent Review Organization whose decision binds the plan. You don't need an attorney for any of this.
What are the steps?
1. Read the denial letter carefully — find the specific reason; 2. Request the plan's specific criteria they relied on (you have this right); 3. Gather supporting documentation — chart notes, specialty-society guideline citations; 4. File a written appeal within 180 days (federal floor); 5. If denied, request external review by IRO; 6. Free resources: DenialHelp drafts the letter in 5 min; your state's ACA Consumer Assistance Program offers free help; your state insurance department handles complaints
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