Fix My Claims Podcast: Tips and Strategies to Overcome Insurance Claim Denials
What if your denied insurance claim isn’t the end, but just the beginning of the fight? In the debut episode of FixMyClaim, Mary Covington—a 53-year veteran of the claims industry—reveals the hidden strategies insurance companies don’t want you to know. Why do insurers deny life-saving treatments...
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Navigating insurance claims is like playing a game you didn’t sign up for—one with complicated rules, opaque processes, and an ever-moving target. But for Mary Covington, founder of FixMyClaim and seasoned industry expert with 53 years of experience, this game isn’t just business—it’s a personal mission. In the debut episode of FixMyClaim, guest host Chris Farrell takes listeners through Mary’s journey, her strategies, and the lessons she’s learned from a lifetime of fighting insurance denials.
Mary doesn’t just play the game—she plays to win. And now, through her podcast, she’s showing others how to do the same.
From a Career Twist to a Calling
Mary’s journey into claims started when she was just 14, moving from New York to Idaho and later to Salt Lake City, where she landed a job with Aetna Life and Casualty. “I was originally planning to go to law school,” she shares, “but I started at the bottom, worked my way up, and learned everything there is to know about insurance claims.”
That first job launched a career she never planned but now wouldn’t trade. Over the years, Mary developed a deep understanding of the industry—from processing claims to uncovering the systemic issues families face when insurers deny payments.
"Insurance isn’t something we learn in school," she explains. "But one day, we all deal with it—whether it’s medical, disability, or life insurance. And when a claim is denied, most people feel lost."
The Claim Game: Play It or Pay for It
Mary likens insurance claims to a strategy game—one that families have no choice but to play, often without knowing the rules. “Games were a big part of my childhood,” Mary reflects. “I have five brothers and three sisters, so you learn to strategize to win. Insurance claims are no different.”
One of Mary’s top pieces of advice? Don’t call the insurance company immediately after receiving a denial. “That phone call can be counted as an appeal,” she warns, “and verbal appeals leave no paper trail in the administrative record.” Instead, Mary encourages clients to start with their policy:
“Put on your investigator hat. Look at the exclusions. What did they deny and why? Was it valid?”
Her method is simple but essential: build a solid case before contacting the insurer. “Always gather evidence and put everything in writing. Strategy begins with preparation—without it, you risk playing right into the insurance company’s hands.”
Facing Denials: Real-Life Stories
Mary’s experience is filled with eye-opening stories. One case still leaves her shaking her head:
“A man reached out to me after his wife’s emergency appendectomy was denied as ‘not medically necessary.’” She laughs in disbelief. “You think you’ve heard it all—until you haven’t.”
In another case, Mary helped a man who became a quadriplegic after a motorcycle accident. Initially denied COBRA benefits due to alleged “gross misconduct” for spraying water with a co-worker, the man was left without the insurance coverage he desperately needed. But Mary saw through the weak justification.
“I thought, ‘A water hose? That’s gross misconduct?’” Mary explains. Her persistence resulted in the coverage he needed for vital equipment and long-term care.
The Emotional and Financial Toll of Denials
Beyond strategy, Mary emphasizes the emotional toll denials place on families. "It’s not just about money—it’s about survival,” she says. A denial notice can create panic, especially when providers demand payments or refuse further care until accounts are settled.
“You’ll be hounded by collection agencies,” Mary warns. “Some providers won’t even see you unless your balance is current.”
For families overwhelmed by the process, she offers reassurance: “You need someone in your corner—someone who knows the system and can take away that stress.” Mary’s passion for her work deepened during her time at a rehabilitation hospital, where she saw firsthand how vital insurance claims were to patients recovering from life-changing injuries.
"When I saw the families’ struggles and what they were up against, I knew I had to help,” she says. “That’s what this is all about—giving people peace of mind and a path forward.”
Why Expertise Matters: Don’t Go It Alone
Many people try to handle claims disputes themselves, only to hit roadblocks. “I’ve seen it all—families writing a few paragraphs for an appeal or making casual phone calls to insurers,” Mary says. “It’s not enough. The next thing they know, they get a letter saying, ‘We’ve maintained our denial.’”
For families who prefer to manage appeals on their own, FixMyClaim offers a “guidance-only” service, walking clients through the process step-by-step. “We help them gather evidence, draft appeal letters, and avoid common mistakes,” Mary explains. “Some people do a pretty good job this way, but we’re with them every step of the way.”
Still, Mary cautions against the risks of going it alone. “If you don’t build a strong enough case from the start, it’s easy to get frustrated and stuck in a cycle of denials.”
The Insurance Industry’s Broken System
Mary doesn’t sugarcoat the challenges families face within a broken system. Many claims denials, she explains, are the result of computer algorithms rather than thorough investigations.
“You go to the ER with chest pain, but the insurance company sees pneumonia as the final diagnosis and denies coverage because they don’t read the full medical record,” Mary shares. “That’s the kind of craziness we deal with every day.”
What’s worse, she says, is the poor customer service. “I can call 10 times about the same claim and get 10 different answers. Families don’t have time to sit on hold for two hours, only to be shuffled off to someone else.”
Mary is committed to improving the system—one claim at a time. “I’m even talking with the Department of Labor and Congress to push for change,” she adds.
A Strong Call to Action
If you’ve received a denial notice, Mary’s advice is clear: act now.
“You only have 180 days to appeal—don’t wait until it’s too late,” she emphasizes. “Your strategy starts the moment you receive that letter.”
The first step is simple: schedule a free consultation. “During that initial call, we review the policy, the denial, and the family’s situation,” Mary explains. “Every claim has a story—and every story needs the right strategy.”
Start your journey today: Visit FixMyClaim.com to schedule a consultation and begin building your case.
Closing Thoughts: Every Claim Has a Story
As the episode concludes, Chris Farrell reflects on what listeners can expect from the FixMyClaim podcast. “Mary isn’t just giving information—she’s empowering people to fight back, to know their rights, and to win their claims.”
Mary closes with a promise: “This is about more than claims. It’s about helping people, one story at a time.”
