Got an insurance denial? Draft the appeal that fights back.
AI drafts a properly-cited appeal letter using your plan terms, ERISA, and applicable law — preview it free before you pay.
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About 50–60% of properly-filed appeals succeed. The denial relies on you not filing one.
What's actually happening.
Your insurance just denied a claim — for medication, a procedure, a surgery, a service. The denial letter is intentionally confusing. The appeal process is intentionally exhausting. Most people give up. We don't. The system works exactly as designed: deny first, approve on appeal when challenged. You just need to file.
What we draft.
I write to formally appeal the denial dated April 2, 2026 of coverage for laparoscopic cholecystectomy (CPT 47562). The denial states the service was "not medically necessary." I respectfully disagree. Under 29 CFR § 2560.503-1 (ERISA), you are required to provide a full and fair review. Per 45 CFR § 147.136, non-grandfathered plans must cover services determined medically necessary by a treating physician. My treating physician Dr. Rafael Ortega documented acute cholecystitis confirmed by ultrasound on February 27, 2026...
Full letter includes: denial reference, three-paragraph substantive argument, statute citations in pull-quotes, procedural deadline notice, and signature block.
How it works.
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Pricing.
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Laws we cite.
We ground every letter in real statutes and regulations. Here's what applies to your situation:
29 CFR § 2560.503-1 Employee Retirement Income Security Act (ERISA) — requires full and fair review of adverse benefit determinations for employer-sponsored plans.
45 CFR § 147.136 ACA — internal appeal rights for non-grandfathered individual and group health plans.
ERISA § 503 Federal appeal rights for employer-sponsored benefit plans, including timelines and documentation requirements.
State external review All states have external review programs for denied claims — an independent reviewer overrides the insurer. We cite the correct one for your state.
Who this isn't for.
We're honest about our limits. FightThis may not be right if:
- Your denial involves Medicare or Medicaid — those have separate federal appeal paths.
- The disputed amount is over $100,000 — you should have an attorney involved.
- You are in active litigation with your insurer.
- You need a peer-to-peer review between your physician and the insurer — that's a separate process FightThis doesn't cover.
If your situation is high-stakes, please find a local attorney. Many state bars have free or low-cost referral services.
Common questions.
How long do I have to appeal?
Most plans give you 60–180 days from the denial date for internal appeals. Check your denial letter for the exact deadline — it's legally required to be there. Don't wait.
What if I already tried to appeal and they denied it again?
After exhausting internal appeals, you typically have the right to external review by an independent organization. FightThis can draft that request too.
Does this work for Medicare?
Medicare has its own separate appeal process. FightThis focuses on commercial insurance (employer plans and ACA marketplace plans). For Medicare, visit medicare.gov/appeals.
What if the denial was for a mental health or substance use service?
Mental health parity rules (MHPAEA) give you additional protections. Our letter will specifically invoke these where applicable.
Will I need my doctor to write anything?
For the strongest appeal, a supporting letter from your treating physician helps significantly. Our letter will request peer-to-peer review or a physician letter as part of the appeal strategy.
What if my employer is self-insured?
Self-insured plans are governed by ERISA and are exempt from state insurance laws. Our letter handles this — we identify the right framework based on your plan type.
We mail it for you
Insurers count on the 30-day appeal window passing without a properly postmarked letter. Mail it certified with tracking through FightThis — your proof that you met the deadline.
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