How to Appeal Rejected Insurance Claims - A Legal Guide

It can be difficult and frustrating to deal with a denied insurance claim. However, understanding the reasons for claim rejections and how to appeal them can greatly improve your chance of success. This in-depth guide will cover the common reasons for insurance claim denials, dispute resolution processes, advice for avoiding similar denials in the future, and how to find the best assistance for your insurance claim dispute.

Thankfully, Aussie Injury Lawyer’s team of skilled insurance litigation lawyers provides advice on a 100% No Win, No Fee basis. Contact us immediately to learn your rights and how we can help when an insurer refuses to payout.

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Rejected Insurance and TPD Claims

When an Australian insurance company denies your insurance claim or TPD claim, there is no need to panic. You do not need to accept their decision. There are options to challenge your insurer’s assessment and reverse their judgement so you can access your entitlements.

Regardless of the kind of insurance claim that has been rejected, there are options to appeal, including:

Why choose Aussie Injury Lawyers

Rejected or Denied Insurance & TPD Claims

99% Success Rate

At Aussie Injury Lawyers, 99% of our insurance claims are successful. Due to our many years of legal experience in these types of legal matters, most of our claims succeed without needing to litigate. Should your insurer deny your entitlements in the first instance, we would argue your case on your behalf and seek to have their decision reversed without litigation (which can be costly, stressful, and not consistently successful).

All insurers and superannuation funds have a formal appeals procedure and regularly deal with these complaints. We may need to provide additional evidence or reports to support your claim. Be aware there are type limits for Super funds to respond to your appeal. So you may not have to wait too long to receive an answer.

Common reasons for a Rejected Insurance Claim

Rejected insurance claims can be a significant financial burden, particularly when you believe your insurance policy should offer cover for your circumstances. Generally, the first step towards successfully appealing a rejected claim is understanding the most common reasons for refusal.

  • You are still capable of working.
  • Not enough medical evidence
  • You could be employed in another occupation
  • Not meeting policy conditions
  • You haven’t yet reached “maximum medical improvement.”
  • Failing to disclose information

If you are unfortunate to have your insurance claim denied, chat with one of our experienced insurance lawyers. They will find the best legal strategy for your case.

Time Limits for Challenging Denied Insurance Claims

If you are disputing the outcome of a TPD, Income Protection or other type of insurance claim, time limits may apply. So please immediately speak with one of our legal team for free initial advice. Call 1300 873 252

How can Aussie Injury Lawyers Help You?

Our experienced insurance claim dispute lawyers will:

  • Let you know if you have a valid case
  • Lodge a dispute with your Super fund/insurer
  • If you don’t achieve a settlement, possible litigation


Contact us now for a free case assessment

Litigation (Going to Court)

Aussie Injury Lawyers rarely litigate an insurance claim in court. We would not take your claim to court unless you instructed us to do so. Time limits for court claims also apply.

It is possible to lodge a court case for a rejected insurance claim against solely your insurer or your insurer and superannuation fund. Procedures for litigating in court vary from State to State and for different jurisdictions.

Here is how the process works typically:

  1. A proceeding (statement of claim) is lodged with the court
  2. Your super fund/insurer lodges a response
  3. Disclosure – both parties exchange documents
  4. Usually, mediation will occur
  5. If mediation fails, the matter proceeds to court.

Litigation can take a significant amount of time and be stressful and expensive. It can force your insurer to make a serious consideration of your case. However, there is no guarantee you will win. If your litigation succeeds, you may also be able to claim additional damages.

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Meet Your Legal Team

Hardworking and straight talking, our experienced superannuation and insurance legal team is dedicated to delivering results for you. We understand how challenging life can be when things go wrong and we are here to help you get back to normal. The expert team at Aussie Injury Lawyers is led by Kerry Splatt, an Accredited Specialist in Personal Injuries law. His expertise together with over 100 years of combined legal experience is your guarantee of success. Reach out. Let us show you how we can assist you and your loved ones when the unexpected happens.

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