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N584 Remark Code: Insured Didn't Meet Policy Conditions

N584 means the payer denied coverage because the insured did not comply with conditions required by the policy or by statute. Examples include late notice of the claim or failure to meet a legal requirement tied to the coverage.

Quick facts

Code
N584 (RARC N584)
Status
Active In use since July 15, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • OA (Other Adjustment): The carrier denies liability based on the insured's conduct. The balance may shift to another payer.
  • PR (Patient Responsibility): Some carriers assign the amount to the patient, subject to state law and other available coverage.
Official description
Not covered based on the insured's noncompliance with policy or statutory conditions.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N584 means

Insurance policies and state insurance laws impose duties on the insured, the person who holds the coverage. If those duties are not met, the insurer may refuse to pay. N584 says that is the basis for this denial: the insured’s noncompliance, either with the policy’s conditions or with a statute.

It is used mostly by property and casualty carriers and typically appears with CARC P6, P21, or P27.

Common causes

  • Late notice. The accident or claim was not reported to the insurer within the time the policy requires.
  • Coverage requirements not met, such as a vehicle that was not properly insured or registered under state law.
  • Other policy conditions, like failing to submit a required proof of loss.

What to do

  1. Ask the carrier which condition was not met and request the explanation in writing.
  2. Share it with the patient. If the patient is the insured, they may be able to cure or dispute the problem.
  3. Find other coverage. Health insurance or another auto policy may now be the right payer. See coordination of benefits denials.
  4. Check state rules before billing the patient directly, since some states limit balance billing for accident-related care.

How to prevent it

You cannot control the insured’s compliance, but you can reduce surprises: at the first visit, confirm that a claim has been opened, note the claim number, and ask the patient whether the carrier has requested anything from them.

Codes that may appear with N584

  • CO-P6 (Based on entitlement to benefits.): Denied based on entitlement to benefits.
  • CO-P21 (Payment denied based on the Medical Payments Coverage (MPC) and/or Personal Injury Protection (PIP)): Denied under PIP or medical payments jurisdictional rules.
  • CO-P27 (Payment denied based on the Liability Coverage Benefits jurisdictional regulations and/or payment policies.): Denied under liability coverage rules.
  • N580 (Determination based on the provisions of the insurance policy.): Based on the policy's provisions without specifying noncompliance.
  • N582 (Benefits suspended pending the patient's cooperation.): Benefits suspended until the patient cooperates.
  • N589 (Coverage is excluded to any person injured as a result of operating a motor vehicle while in an intoxicated condition or while the ability to…): Excluded because the person was operating a vehicle while impaired.

N584 FAQ

What counts as a policy or statutory condition?

It varies. Common examples are giving timely notice of an accident, carrying required coverage, or meeting obligations a state's insurance law places on the insured. The carrier should be able to name the specific condition.

Is the provider at fault?

Usually not. N584 concerns the insured's obligations, not the provider's billing.

Can the denial be reversed?

Sometimes, if the insured can show the condition was met or an exception applies. That dispute is typically between the insured and the insurer.