Insurance Appeal Deadlines

What Happens If You Miss Them — and Why Timing Matters

Insurance appeals are not usually lost because the claim is weak. They are lost because the clock ran out.

Most people assume they have time to think, research, or wait for another bill. In reality, insurance appeals operate on strict deadlines, and once those deadlines pass, even strong appeals can be permanently closed.

This page explains:

  • Common insurance appeal deadlines

  • Why delays quietly kill valid appeals

  • When exceptions sometimes apply — and when they don’t

The Most Common Insurance Appeal Deadlines

While deadlines vary by plan, insurer, and state, these timeframes are extremely common:

⏱ 30 Days

Often applies to:

  • Urgent or expedited appeals

  • Certain employer or plan-specific appeals

Miss this window and the appeal may never be reviewed.

⏱ 60 Days

Common for:

  • Initial internal appeals

  • Post-service denials

This is one of the most frequently missed deadlines — especially when people wait for medical records or billing corrections.

⏱ 180 Days

Very common for:

  • Health insurance internal appeals

  • ERISA-governed plans

Important: 180 days sounds long — but it passes quickly when people are confused, overwhelmed, or waiting for “one more letter.”

Why Delays Kill Otherwise Valid Appeals

Insurance companies do not evaluate appeals the way people expect.

They often do not decide appeals based on fairness. They decide them based on compliance.

Common delay-related problems include:

  • Appeals rejected as “untimely” without reviewing the merits

  • Appeals closed administratively

  • Loss of the right to submit additional evidence

  • Inability to escalate to the next appeal level

Once a deadline is missed, insurers rarely explain what rights were lost — they simply close the file.

Waiting Feels Safe — But It Isn’t

Many people delay because:

  • They don’t understand the denial

  • The denial language is vague or confusing

  • They’re unsure which appeal letter to use

  • They hope the issue will “resolve itself”

Unfortunately, waiting does not preserve your rights.

Deadlines keep running even while:

  • You request records

  • You speak with billing offices

  • You research online

  • You try to write an appeal from scratch

When Exceptions Sometimes Apply

There are limited situations where late appeals may still be reviewed, such as:

  • Misleading or unclear denial notices

  • Incorrect deadline information from the insurer

  • Ongoing treatment or urgent care situations

  • Certain ERISA or plan-specific rules

However:

  • Exceptions are not automatic

  • They usually require careful framing

  • Insurers are not required to tell you that an exception might apply

You cannot rely on an exception unless it is raised correctly.

The Practical Takeaway

You do not need to have everything perfect before you act.
You do need to act before the deadline expires.

The safest approach:

  1. Identify the type of denial

  2. Use the correct appeal structure

  3. Submit a timely appeal — even if additional records will follow

This preserves your rights and keeps the appeal alive.

If You’re Unsure What to File

If you’re still unclear:

👉 Browse Appeal Letter Templates (Designed to help you act correctly and on time)

Appeal deadlines do not announce themselves. They simply pass.

Understanding your denial matters — but timing determines whether it can still be fixed.