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.

Do you have a Claim?

Find out now. AIL has a 99% success rate for TPD Claims. Our expertise is your guarantee of success.

Get started >

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:

Guide for rejected TPD claims >

Why choose Aussie Injury Lawyers

Free Legal Advice
Capped Fees
100% No Win No Fee
99% Success Rate
No Legal Costs during your case
Fast Track Settlements
We do not charge Uplift Fees

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

What's my claim worth?

Get a Fast Estimate with our Online Calculator

Begin Calculation>

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:

A proceeding (statement of claim) is lodged with the court
Your super fund/insurer lodges a response
Disclosure – both parties exchange documents
Usually, mediation will occur
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.

Read our 5 star reviews

My partner was unable to work & we had no choice but to apply for a TPD payout. Aussie Injury Lawyers’ prompt and professional service lead to a very successful outcome. We can’t thank them enough.

D.LManly West

Very happy and thankful for the outcome from Ellie Clark and Nigel very well organised, Great service, very professional and responsive and handled my case with care. I definitely recommend Aussie injury lawyers, they get the job done when needed and was so much easier than I thought, I couldn’t believe how good they were to me great teamwork! They made me and my family really happy thank you again for you’re amazing hard work and handling it in a professional way Best lawyers I’ve ever came across, if anyone needs a good helpful honest lawyer this is the place! All the best

Trena

If any one can no longer work due to an injury or sickness do yourself a favour and contact Aussie injury lawyers.Ellie and Nigel have been fabulous in getting my case over the line. Their professionalism has been outstanding keeping me informed throughout the process thank you for all your hard work

Murray

Emma and Isabella were absolutely fantastic with respecting my wishes, representing me in a professional and respectful manner and supporting me the whole way. I couldnt have done it without them

Gen

The team at Aussie Injury Lawyers are professional and really know their stuff. I recommend anyone who has any legal needs in this department should consider Aussie Injury Lawyers. They are no win no pay take it from myself when you win their fee is low

Shane

If you want professional, friendly service then ring Aussie lawyers Nigel and Ellie assisted me through a very upsetting time showing compassion and made the whole experience possible, I feel I have made friends once again thankyou for being so amazing you are definitely angels.

Maureen

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.