If your insurer hasn't responded to your appeal, discover how to check status and enforce review deadlines.

We know how frustrating it is to feel ignored by your insurance company, especially when your health is on the line. But you don’t have to wait endlessly—your insurer is legally required to review and respond to your appeal within set timelines.
If you haven't heard back about your appeal–here's how to hold them accountable and make sure they stick to their deadlines.
Quick Summary – More details below:
Call member services for a status update—you deserve quick answers.
Use the tips below to get results and avoid delay tactics.
If you're being ignored, file a complaint with their regulator—they’re there to help!
"Never give in, never give in, never, never, never, never—in nothing, great or small, large or petty—never give in except to convictions of honor and good sense." –Winston Churchill
How long does my insurer have to review my appeal?
The Affordable Care Act and ERISA regulations set strict rules for how appeals are handled: who reviews your appeal, how and when they must share decisions, and the specific timelines they must follow. Below are the general review timelines, but be sure to check your denial letter for specifics to your plan.
If your appeal is for… | Expedited Service | Experimental Service | Upcoming Service | Received Service |
Your timeline is… | 72 hours | 7 days | 30 days | 60 days |
You can request an expedited appeal if waiting for a claim decision may put your health at risk, such as if you urgently require medication due to a risk to health or severe pain, or are currently in the hospital.
How do I know when my appeal was received?
We submit your appeal via Fax and First-Class Mail with tracking to ensure delivery. You’ll receive an email receipt confirming when your appeal was faxed, and mail delivery typically takes 3-5 days. If there’s an issue with delivery, we’ll let you know and work on alternative methods. If you need a detailed tracking report–reach out to support@getclaimable.com.
How can I find out my appeal status?
Call the member services number on the back of your insurance card and ask for an update on your appeal. Sometimes your provider may receive updates faster, so it’s worth checking with them too.
Can Claimable contact my insurer for me?
Your appeal is 100% yours—Claimable helps you create and send it, but we don’t contact your insurer directly or receive updates on your behalf. Because of this, you, in addition to your health provider, will be the ones to receive any updates or decisions from your insurance company.
How Can I Check My Appeal Status?
Unfortunately, insurers often use delay tactics to avoid processing appeals. Here’s how to handle common excuses:
They say: “We never received your appeal.”
You say: “I have proof it was received on [date] at [fax number] and on [date] at [address]. Please check again. I’ve also copied regulators, your CEO, and other decision-makers. Let me know if you need a detailed tracking report.”
They say: “We need more time to review.”
You say: “No, unless you can provide a valid reason in writing today that meets legal criteria for an extension. The law requires a decision within [review days], and I’ll file a complaint with [regulator] if there’s no compliance.”
They say: “You can’t appeal.”
You say: “Under the Affordable Care Act (or ERISA for self-funded plans), I have the right to appeal, including requesting exceptions to plan policies like step therapy or formularies when medically necessary. I am entitled to my own internal and external appeals, in addition to any requests or appeals sent by my health provider.”
What If I Don’t Hear Back?
Ignoring appeals is illegal. If your insurer doesn’t respond within the required timeline, you should file a complaint with your regulator—typically your state's Insurance Commissioner or the Department of Labor if you're on a self-funded plan.
Here's a breakdown of who to file a complaint with, depending on your plan type:
Department of Labor (EBSA / ERISA): For self-funded employer plans
State Departments of Insurance: For fully-insured employer plans, state or local government employers, and individual or exchange-purchased plans
Centers for Medicare and Medicaid Services: For Medicare and Medicare Advantage plans
State Medicaid Agencies: For Medicaid plans
Office of Personnel Management : For federal employer plans
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