Why Was My Home Insurance Claim Denied?
Ron Glaser | Sep 25, 2024
You've just experienced a catastrophic incident, such as a fire or severe storm, which damaged your home and property. You filed your insurance claims only to have them denied. As devastating as it can feel, know that all is not lost. Sadly, many insurance companies will work hard to find any excuse to underpay or deny an insurer’s claim. Keep reading to learn more about your rights and find out how you can fight for the money you are owed.
6 Reasons Your Home Insurance Claim May Have Been Denied
1. Non-Payment of Premiums: Failure to pay your insurance premiums (the amount you pay each month to keep your policy active) is a breach of your insurance contract, which means the insurer has the right to deny your claim.
2. Late Filing: Your insurer can deny your claim if you fail to file the paperwork within the timeframe outlined by your policy.
3. Insufficient Documentation: One of the most common reasons insurance companies deny a claim is because of insufficient evidence. Consider including paperwork, receipts, videos, photos, or even witness statements to fully support your claim.
4. Suspicious Circumstances: Insurers might suspect foul play and deny a claim on the accusation of misrepresented information in the evidence.
5. Exclusions: Everyone’s insurance policy is unique. Your insurance company may deny your claim because it falls outside your policy’s coverage parameters. Be sure to always read the fine print and keep a sharp eye out for technicalities and loopholes.
6. Damage is less than Deductible: Insurance typically only covers the cost of repairs that are higher than the deductible. If the cost to repair the damage to your home is below your deductible, then your insurance will likely deny the claim and leave you to pay for repairs out of pocket.
5 Steps to Take After Denial
1. Review your Denial Letter
First, take a close look at your denial letter. This should thoroughly outline the reasons for denial, and there may be a straightforward answer to why your claim wasn’t approved. Was it denied due to being a non-covered event, for wear and tear, or for some other explicitly stated reason? If you believe your claim was wrongly denied, you can file a claim dispute with the insurance company.
2. Gather Additional Evidence
Immediately after the incident occurs, you should always document it with photos and videos. This will help provide evidence to your insurance company throughout the claims process, and if your claim is denied, this photographic evidence can further reinforce the validity of your claim. Additional evidence to gather includes receipts, paperwork, and even records of communication between you and the insurance company. Email correspondence is a great way to ensure you have a paper trail for reference.
3. Contact your Adjuster
When you’re dealing with insurance adjusters, the best thing you can do is contact a contractor or roofer you trust to perform an additional inspection. A second, more neutral opinion helps ensure you’re getting an accurate, unbiased evaluation of your property damage and can aid in appealing your claim.
4. Request a Re-evaluation.
If your insurance claim is denied, you have the right to dispute the decision. Contact your adjuster and request a re-evaluation.
5. Seek Professional Help
Sometimes, there’s only so much you can do without the help of a trained professional. The fact of the matter is, insurance companies want to retain as much money as they can, and you may have to fight for the coverage you're owed. Having an experienced and knowledgeable attorney advocate for you can make the process more efficient with less effort on your end and more likely to end up in your favor.
Preventing Future Insurance Claim Denials
Understand your policy. Studying your policy can help you better navigate the claims process in the future. Once you understand the nuances and loopholes of your unique insurance policy, you can begin to anticipate what is and isn’t covered when disaster strikes next.
Schedule regular maintenance and document it. To help support your case for potential future damage and claims, be sure to schedule regular check-ups, cleanings, and maintenance of your property. Also, make sure to keep records and receipts of the repair work. Showing that you make every effort to keep your property in tip-top condition can make a difference in future claims and disputes.
Be prompt in reports and filings. Maintain responsive, articulate, and timely communications with your insurance company and with your legal team, should you decide to pursue that path.
