Maria Teresa Borges de Almeida Jul 16, 2021:

Tb pode ser útil Em complemento da sugestão do Adrian
https://www.proz.com/kudoz/portuguese-to-english/law-contrac...

expressisverbis Jul 15, 2021:

Pode ser muito útil: It can be extremely distressing if an insurance provider decides to deny coverage of treatment. Fortunately, there are options available for asking the insurance provider to reconsider their decision and for letting them know why they should – this process is called “appealing.”

Appealing means asking an insurance company to reconsider its decision to deny paying for a therapy or service. You have the right to appeal a denied claim up to six months after receiving the decision. [Editor’s Note: The US healthcare landscape is always changing, and diaTribe will be keeping a close eye on how any policy changes affect the accuracy of this article.]
https://diatribe.org/when-insurance-gets-turned-down-appeals...

Não sei se existe um termo específico em português (br ou pt), mas sei que uma companhia de seguros que recusa uma cobertura de seguro de saúde, o segurado, pelo menos cá, não pode recorrer dessa decisão/avaliação... pelo menos, em Portugal, há uns anos atrás, não.