Grievance Procedure

What Does Grievance Procedure Mean?

A grievance procedure is a process through which two or more parties seek to resolve a dispute. In the context of insurance, grievance procedures typically arise when a policyholder believes they are entitled to coverage for a specific loss, but the insurance company disagrees. Each state has its own laws governing grievance procedures.

Insuranceopedia Explains Grievance Procedure

Grievance procedures are common in many industries and organizations. For instance, labor unions often have their own grievance procedures. In the case of insurance companies, a grievance procedure typically begins with an evaluation of the claim. If the claim is rejected and the policyholder appeals, the insurance company may then evaluate the appeal. If no resolution can be reached, a lawsuit may follow, with the insurance company defending itself against the policyholder’s claims that coverage is owed.