Terms of Service

Last updated: 2026-05-08

These Terms of Service (“Terms”) are a legally binding agreement between you (“you” or “User”) and DenialHelp, LLC, a Delaware limited-liability company (“DenialHelp”, “we”, or “us”). By accessing our website, submitting information, or using our Services, you accept and agree to these Terms. If you do not agree, do not use the Service.

1. Nature of the Service

DenialHelp, LLC is a document-drafting and informational-tools service. Based on information you provide and publicly available insurer medical policies, we generate written drafts for: first-level medical-necessity appeal letters; second-level internal appeal letters; external-review (Independent Review Organization) request letters; peer-to-peer call briefs; and an executive-summary cover sheet that accompanies each letter. We also provide informational tools (such as the No Surprises Act qualification screener, the state insurance commissioner directory, and federal appeal-rights summaries) that are reference material, not legal advice. We:

• Are not a law firm and do not provide legal advice or legal representation.
• Are not a medical practice and do not provide medical advice, diagnosis, or treatment.
• Do not establish a physician-patient relationship, attorney-client relationship, or fiduciary relationship with you.
• Do not guarantee that any appeal will succeed, or that an insurer will respond within any particular timeframe.

Any letter we produce is a DRAFT intended for your treating physician’s independent review. Your physician is solely responsible for verifying all clinical facts, determining medical appropriateness, and deciding whether to sign and submit the letter.

2. User Responsibilities

You represent and agree that:

• All information you provide (denial letter, medical history, prior attempts, BMI, comorbidities, physician details) is true, accurate, and your own, to the best of your knowledge.
• You are at least 18 years old and legally authorized to request an appeal on the relevant account.
• You will obtain any necessary consent from the patient if you are submitting on behalf of another adult.
• You will have your treating physician independently review, verify, and sign any letter before submission to any insurer.
• You will not submit any letter as your own work or represent yourself as a physician.

3. No Outcome Warranty

Appeal outcomes depend on many factors outside our control, including your insurance plan’s specific exclusions, the reviewing physician’s clinical judgment, state and federal law, and the insurer’s internal processes. We make NO representation or warranty that any appeal will succeed, that coverage will be granted, or that any particular result will be achieved. Any win-probability, letter-strength score, adversarial-review verdict, or other quantitative or qualitative estimate displayed in the Service is an internally calibrated heuristic, not a representation, prediction, or guarantee of any actual outcome, and should not be relied upon as such.

4. Fees and Refunds

Our current standard fee is $39 USD per first-level appeal letter drafted (other levels priced separately on the pricing page; bundle available). Except during any advertised free beta period.

Money-back guarantee. If, after reviewing your denial letter, we determine the denial is legally unappealable (for example, your plan has an explicit exclusion for the medication type), we will refund the fee you paid, LESS any non-refundable third-party payment processing fees we incurred (typically 2.9% plus $0.30 USD charged by our payment processor). This refund is our sole remedy in such cases.

Refund eligibility does not extend to: appeals that are submitted and denied by the insurer; appeals where the user provides inaccurate information; appeals where the user chooses not to submit the generated letter; or any outcome other than a determination of unappealability during our drafting process.

5. Medical and Legal Disclaimer

THE SERVICE DOES NOT CONSTITUTE MEDICAL ADVICE, MEDICAL OPINION, LEGAL ADVICE, OR LEGAL OPINION. LETTERS ARE INFORMATIONAL DRAFTS. YOU AGREE NOT TO RELY ON ANY LETTER, CONTENT, OR COMMUNICATION FROM DENIALHELP AS A SUBSTITUTE FOR ADVICE FROM A LICENSED PHYSICIAN OR ATTORNEY LICENSED IN YOUR JURISDICTION.

You agree to consult your treating physician before acting on any information in our letters. Nothing in a letter should be interpreted as a prescription, diagnosis, or treatment recommendation from DenialHelp.

6. Limitation of Liability

To the maximum extent permitted by applicable law, DenialHelp, its officers, directors, employees, contractors, and affiliates (collectively, “DenialHelp Parties”) shall not be liable for any indirect, incidental, special, consequential, punitive, or exemplary damages, including but not limited to damages for loss of profits, goodwill, medical outcomes, coverage decisions, health outcomes, or other intangible losses, arising out of or relating to these Terms or the Service, even if we have been advised of the possibility of such damages.

In no event shall DenialHelp’s total cumulative liability to you exceed the total fees you actually paid to us in the twelve (12) months preceding the event giving rise to the claim.

Some jurisdictions do not allow exclusion or limitation of liability for incidental or consequential damages, so the above limitation may not apply to you. In those jurisdictions, liability is limited to the greatest extent permitted by law.

7. Indemnification

You agree to defend, indemnify, and hold harmless the DenialHelp Parties from and against any claims, liabilities, damages, losses, costs, and expenses (including attorneys’ fees) arising out of or related to: (a) any information you provided that was inaccurate or incomplete; (b) your submission of a letter to an insurer; (c) any action or inaction by any physician (including your failure to obtain independent physician review); (d) any medical outcome, coverage decision, or legal matter; or (e) your breach of these Terms.

8. Arbitration Agreement and Class Action Waiver

You and DenialHelp agree that any dispute, claim, or controversy arising out of or relating to these Terms or the Service shall be resolved by binding arbitration administered by the American Arbitration Association (“AAA”) under its Consumer Arbitration Rules. The arbitration shall take place in Wilmington, Delaware, or by video conference at the arbitrator’s discretion. Judgment on any arbitration award may be entered in any court having jurisdiction.

You and DenialHelp agree that each may bring claims only in your or its individual capacity and not as a plaintiff or class member in any purported class or representative proceeding. The arbitrator may not consolidate more than one person’s claims and may not otherwise preside over any form of representative or class proceeding.

If any portion of this arbitration agreement is found unenforceable, the remainder shall remain in effect, except that if the class-action waiver is found unenforceable, the entire arbitration agreement shall be void.

9. Privacy and HIPAA

We handle protected health information (“PHI”) in accordance with our Privacy Policy and applicable HIPAA regulations. By using the Service, you consent to our collection, encryption, storage, and use of PHI to draft your appeal letter.

10. Governing Law

These Terms shall be governed by and construed under the laws of the State of Delaware, without regard to its conflict-of-law rules. The United Nations Convention on Contracts for the International Sale of Goods does not apply.

11. Termination

We may terminate or suspend your access at any time, with or without notice, for conduct that we believe violates these Terms or is harmful to other users, us, or third parties.

12. Changes to Terms

We may modify these Terms at any time by posting an updated version. Continued use of the Service after changes constitutes acceptance of the revised Terms. Material changes will be communicated via the email address you provided.

13. Severability

If any provision of these Terms is held invalid or unenforceable, the remaining provisions will remain in full force and effect.

14. Entire Agreement

These Terms and our Privacy Policy constitute the entire agreement between you and DenialHelp regarding the Service and supersede all prior agreements and understandings.

15. Removal Requests / DMCA Notices

If you believe that any content on the Service infringes your copyright or other intellectual property rights, or includes your protected health information, personally identifiable information, or other private content without your authorization, please send a written notice to our designated agent.

Designated Agent: Privacy Officer, DenialHelp, LLC. Email: [email protected]. Mailing Address: 1111B S Governors Ave # 50985, Dover, DE 19904.

Your notice must include: (a) your physical or electronic signature; (b) identification of the work or material claimed to be infringed or improperly disclosed; (c) the URL or location of the allegedly infringing or improperly disclosed material; (d) your contact information; (e) a statement that you have a good-faith belief that the use is not authorized; and (f) a statement, under penalty of perjury, that the information in the notice is accurate and that you are authorized to act on behalf of the rights holder or affected individual.

Counter-Notice. If you believe content was removed in error, you may submit a counter-notice to the same address containing the elements required under 17 U.S.C. Section 512(g)(3).

Repeat-Infringer Policy. We will, in appropriate circumstances and at our discretion, terminate accounts of users who are repeat infringers.

Privacy Removal Requests. Removal requests for protected health information (PHI), personally identifiable information (PII), or other private content not implicating intellectual property are processed under our Privacy Policy and the same designated agent above. We will respond to validated requests within 30 days where feasible.