Has your homeowner’s insurance claim recently been denied? Here are common reasons that claims get denied, and what you can do to fight back.
Common Reasons for Denied Claims
Deductible not met
If damage occurs and the repair or replacement is less than your deductible, you cannot file for compensation from your insurance company.
Missed filing deadline
You must file within a set timeline, or your claim can be denied. Insurance companies require prompt notification once damages have occurred, so it’s important to file the claim as soon as possible.
Did you miss your last payment? If an accident or damage occurred when your premium went unpaid, you may have missed out on coverage for the incident.
If you did not provide sufficient data or evidence of the damage, your claim may be denied. That’s why careful documentation is important as soon as the damage occurs.
Look over your policy carefully. Did your claim involve something that is excluded in the fine print? For example, your homeowners policy may include coverage for a basic peril such as lightning, but not a special peril such as an earthquake.
Damage may have happened due to lack of maintenance rather than a sudden occurrence that caused damage. You cannot file a claim for an old refrigerator that quits working and causes water damage due to a leak, for example. You can only file claims for occurrences that are out of your control.
If someone enters your property and causes damage, the liability rests with them and their insurance company, not with your insurance company. You will not be able to collect anything from your insurer if the liability is excluded.
Further damage after a loss
After a loss occurs, you must take preventative measures to protect your property from further loss. For example, if a tornado lifts a section of your roof off, it is your responsibility to immediately patch the hole to keep water from entering your home. If you don’t take preventative measures, your claim can be denied.
Every time you file a claim, an insurance adjuster will investigate the claim. If the adjuster finds anything that appears to be questionable, suspicious, or fraudulent, a red flag will go up and you may not receive payment.
Disputing an Insurance Claim Denial or Settlement
If you feel like you were unfairly denied an insurance payment or that your settlement is insufficient, a skilled attorney can help you fight back. First, you can take several steps to dispute your claim.
Review your submission
Make sure that your policy covers the damage in question. Then review your claim to ensure that you followed the instructions. Ask your insurer to clarify the reasons for denial.
Take notes during every phone call or face-to-face conversation. You can also get your own estimates for repair.
File an appeal
Write a letter explaining your position and ask the insurer to review your claim again. Send it via certified mail and request a response within a reasonable time frame.
File a lawsuit
About the Author:
John K. Lawlor, a South Florida personal injury attorney who focuses his practice on complex personal injury, wrongful death, and professional malpractice, founded the law firm of Lawlor, White & Murphey in 1998. Since 1995, Mr. Lawlor’s trial advocacy and litigation skills, as well as his wide-ranging legal expertise, have provided plaintiffs and their families with a distinct advantage when seeking financial compensation and justice for injuries caused by the negligence of others. Mr. Lawlor is an EAGLE member of the Florida Bar Association and an active member of the American Association for Justice, the Broward County Justice Association, the American Civil Liberties Union (ACLU), and several professional associations.