Denied Homeowners Insurance Claims

If you've had a homeowners insurance claim denied, it can be a frustrating and confusing experience. Here's what you need to know about denied claims and how to appeal them.

Why Are Homeowners Insurance Claims Denied?

Your home insurance company may deny your claim for a number of reasons. The most common reason is that the damage is not covered by your policy.

Other reasons for denial may include:

  • Your insurance company feels that you caused the damage deliberately or through negligence
  • Your home insurance policy has lapsed or been canceled
  • You didn't provide enough evidence to support your claim
  • Your insurance company determines that the damage isn't severe enough to warrant a payout
  • The cost of repairs exceeds your policy's coverage limit

How Do I Prevent a Denied Insurance Claim?

To file a successful homeowners insurance claim, you will need to show that the damage was caused by a covered event and that it is not excluded from your policy. You will also need to provide documentation of the damage, such as photos or estimates from contractors.

1. Know your policy inside and out

Before you file a claim, take the time to review your policy so that you know what coverage you have and what your deductibles are. This will help you be sure that the cause of damage is covered and that the cost to repair the damage does not exceed your coverage limit or fall below your deductible amount.

2. Make sure your policy payments are up to date

Failure to pay your policy premiums can result in a cancellation of your policy. Make sure your payments are made on time to avoid lapses in coverage. If your payments are made through escrow, it’s a good idea to verify that your mortgage company has the correct policy information on record so payments are made on time.

3. Stay on top of home maintenance

Many claims are denied because homeowners fail to perform routine home maintenance. If your insurance company feels damage to your home was preventable or caused by you, they likely will not pay your claim. Make sure you perform regular maintenance to prevent small issues from causing long-term damage to your home, especially leaks.

When making home improvements, it’s also a good idea to use licensed professionals to avoid damage caused by poor workmanship, as it may not be covered by insurance.

4. Keep good records

Before you file your claim, take detailed photos of the damage and record any important information related to the damage, including dates and estimates for repairs. Once your claim is filed, be sure to document everything related to your claim, including all correspondence with your insurance company. This will give you a paper trail to follow in case there are any issues with your claim.

5. File your claim in a timely manner

Claims that are not filed in a timely manner may be denied. If you experienced damage to your home, it’s important to file your claim as soon as possible to ensure repairs are quickly and that the damage does not get worse over time.

6. Get multiple estimates for repairs

When it comes to repairs or replacements, get multiple estimates before settling on one. This will help ensure that you are getting the best possible price for the work that needs to be done. You should also check with your insurance company to see if they have a list of contractors they work with. Be cautious if a contractor is asking for an assignment of benefits, as some policies do not allow this.

7. Hire a public adjuster

If you want someone on your side who knows the ins and outs of insurance claims, consider hiring a public adjuster. They can help you navigate the process and make sure that you get the best possible outcome for your claim.

What Do I Do If My Homeowner’s Claim Was Denied?

If your homeowners insurance claim is denied, you can start by appealing the decision. The appeals process will vary depending on your insurer, but you'll typically need to submit additional evidence or documentation to support your case. You may also need to appear in front of an appeals panel.

Understand Why Your Claim Was Denied

The first step is to understand why your claim was denied. Your insurance company should have sent you a letter explaining their decision. If you don't understand the reason for the denial, call customer service and ask them to explain it to you. Once you know why your claim was denied, you can start to build your appeal.

Appeal the Decision

If you don’t agree with the outcome of your claim and you feel the damage should be covered, you can appeal the decision. The appeals process will vary depending on your insurer, but you'll typically need to submit additional evidence or documentation to support your case, including any documentation that proves that your home was in good condition before the damage occurred. You may also need to appear in front of an appeals panel.

Hire an Attorney

While it's possible to fight a denied or undervalued claim on your own, there are several benefits to hiring an attorney to help with your case.

An experienced attorney will know how to navigate the insurance claims process and will be familiar with the common tactics used by insurance companies to deny claims. An attorney can also help gather evidence to support your claim and negotiate with the insurance company on your behalf.

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