CARC Code

P11

🟡 Soft Denial

Property & Casualty Claim Pending Litigation

Payment is being held because there is an active lawsuit related to the injury or illness that caused the claim. This code only applies to property and casualty insurance claims, not standard health insurance.

contractual
Resolution: 85%Easy difficulty3-7 days avg

How to resolve this denial

Review and resolve CARC P11: The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation.

  1. 1

    Review the full denial on the 835 ERA for CARC P11: "The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation."

  2. 2

    Pull the original claim and all supporting documentation for the date of service.

  3. 3

    Identify the specific data element, policy requirement, or documentation gap that triggered this adjustment.

  4. 4

    Correct the identified issue — update claim data, gather missing documentation, or verify coverage details.

  5. 5

    Resubmit as a corrected claim (frequency type 7) or file a written appeal with supporting documentation.

  6. 6

    Follow up with the payer within 10-15 business days to confirm adjudication.

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✓ Pre-action checklist — verify before contacting the payer
  1. Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.

  2. Verify the claim was submitted with correct patient eligibility and benefit information.

  3. Check if this denial applies to a specific line item or the entire claim.

More about PI-P11 — stats, related codes, appeal template

85%

Recovery Rate

3-7 days

Avg. Resolution

Easy

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC P11 by specialty.

General

Confirm payer-specific policy for CARC P11 and submit corrected claim or appeal as appropriate.

Appeal Letter Template

Generic appeal template for CARC P11 denials.

Dear [Payer Name] Appeals Department, We are writing to appeal the denial of claim [CLAIM #] for patient [PATIENT NAME] (Member ID: [ID]) for services rendered on [DATE OF SERVICE]. The claim was denied with CARC P11: "The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation." We believe this denial is in error for the following reasons: [INSERT CLINICAL/ADMINISTRATIVE JUSTIFICATION] We respectfully request reconsideration and payment of this claim. Sincerely, [Provider Name / Billing Contact]

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