Don't miss your window. Enter your denial date and plan type to see exactly when your appeal deadlines expire.
If you miss the internal appeal deadline, you may lose your right to appeal and to external review. However, some plans allow "good cause" extensions, and you can always file a complaint with your state insurance department or regulatory body. Act as soon as possible — don't assume you've lost all options.
Some insurers and regulators grant extensions for good cause (e.g., waiting for medical records, hospitalization). Under ERISA, if the plan fails to follow proper procedures in denying your claim, the deadline requirements may be relaxed. Contact your insurer in writing to request an extension.
An internal appeal is reviewed by your insurance company — a different person or team re-examines your claim. An external review is conducted by an independent third party who is not employed by your insurer. External reviews are binding on the insurer in most jurisdictions.
No. Most successful appeals are filed by individuals without legal representation. The key is citing the correct plan language, medical evidence, and regulations. Tools like ClaimBack can generate regulation-citing appeal letters in minutes, giving you the same level of legal precision a lawyer would provide.
Our calculator covers appeal deadlines for these insurance plan types and more.