Reference Library

Insurance Appeal Templates

Denied a claim? These ready-to-use letter templates help you push back on insurance decisions with confidence — free to copy or download.

What is an insurance appeal?

When your health insurance denies a claim or prior authorization request, you have the legal right to appeal that decision. An appeal is a formal written request asking the insurer to reconsider.

Most insurers allow two levels of internal appeals before you can request an external review by an independent organization. You typically have 180 days from the denial notice to file a Level 1 internal appeal.

How to use these templates: Choose the template that best matches your situation, click “Copy to Clipboard” or “Download .txt,” then replace every [PLACEHOLDER] field with your actual information. Attach your doctor's letter of medical necessity and any supporting documentation before sending.

Step 1

Choose your template

Select the scenario that matches your denial

Step 2

Fill in your details

Replace every [PLACEHOLDER] with real information

Step 3

Attach documentation

Include your doctor's medical necessity letter

Important: These templates are provided for informational purposes only and do not constitute legal advice. Every insurance situation is unique. Consider consulting a patient advocate, healthcare attorney, or your state's insurance commissioner for complex disputes.