For insurance agents

What to write when a claim is denied

A denial email has one job that is not obvious: make it clear you are still on their side while being completely accurate about what happened. Those two things pull against each other, which is why this one is hard to write.

When to send it

The same day you find out. A denial the client hears about from the carrier first is a denial you no longer get to explain.

What it has to do

• States the outcome in the first line. Burying it reads as hiding it.
• Gives the carrier's actual reason, in plain words, without editorialising.
• Says what happens next — appeal, supplemental documentation, or nothing — and who does it.
• Offers a phone call. A denial is not an email conversation and pretending otherwise prolongs it.

What to avoid

• Speculating about whether the denial was right. You may be correct and it is still not your call to make in writing. If you think it is wrong, say you are looking into it, then look into it.
• Promising an outcome on an appeal. 'I'll get this overturned' is a sentence that gets quoted back to you.
• Apologising for the carrier's decision as though it were yours. It muddies who decided what, and it does not actually comfort anybody.

A worked example

Hi Mark,

The carrier denied the claim. I want to walk you through why, and what we can do.

Their reason is that the damage was recorded as wear over time rather than a single event, and wear isn't covered under the policy. That's the distinction the whole decision turns on.

If there's anything showing this started with a specific storm — photos from before, a repair invoice, a neighbor who had the same thing — that's the kind of evidence an appeal is built on. I'd rather look at what you have than guess.

Can you talk tomorrow? I'd rather do this by phone than email.

Richard

Names and details here are invented. Written the way an agent would actually send it, not the way a template would.

More like this

• The renewal reminder email that starts a conversation
• Telling a client their rate went up
• Following up on a quote without nagging