Denial Letter Checklist

Federal law requires insurance companies to include specific information in every denial letter. Missing elements make your denial legally defective — giving you powerful grounds for appeal.

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Start checking your denial letter

Mark each item as "Present" (in your denial letter) or "Missing" (not in your denial letter)

Section A — Required Content of Denial Notice

8 Required Elements (ERISA/ACA)

Section B — Insurer's Procedural Obligations

5 Required Elements

Section C — Appeal Rights Notice

4 Required Elements

⚠️ Procedurally Defective Denial Detected

Your denial letter is missing 0 required element(s). Under ERISA §503 and 29 CFR §2560.503-1, a denial that lacks these required elements may be considered procedurally defective. This can be used as a basis to challenge the denial and may entitle you to additional appeal rights or remedies. Include this finding in your appeal letter.

Summary

Generate Appeal Letter Check External Review Eligibility