When you’re trying to pick up the pieces after fire, flood, or storm damage, one of the last things you want to hear is that your homeowner’s claim has been denied. However, the unfortunate reality is that insurance companies do not make their money by being forgiving during the claims process.
Through loopholes and nuances in your policy, they’ll try to find ways to deny your claim so that they don’t have to pay you a settlement. However, just because your claim has been denied doesn’t mean that the fight stops. Read on to learn why your insurance company may have denied your claim and how you can appeal the denial to get the money you deserve.
Reasons Your Insurance Company May Have Denied Your Claim
Insufficient Coverage
While it’s true that homeowner’s insurance covers a lot, it doesn’t cover everything. There are common “exclusions”, such as flooding, earthquakes, and sewage back-ups, that aren’t included in most policies. In order to be covered for these events, you would need to have purchased additional coverage. If you try to file a claim for one of these events without the additional coverage, your claim will be denied.
Missed Premium Payments
One of the quickest (but most easily avoidable) ways to get your claim denied by your insurance company is failing to pay premiums. While the rest of the world understands that life can get busy and payments can fall to the wayside, your insurance company will not. If you miss or are late on too many payments, your policy will likely lapse, and your coverage will cease.
Not Enough Evidence or Documentation
Insurance companies are not going to take your word for it—they want cold, hard proof that damage took place on your property. Evidence can include photos, videos, or witness statements, and the more you have, the better. Insurance companies rely on this documentation to make a final decision regarding your claim, and failure to provide enough can cause it to be denied.
Damage Doesn’t Exceed Deductible
When your property suffers from damage, you’re required to pay up to your deductible before the insurance company comes in and contributes money towards the remaining expenses. That means if the loss ends up being below your deductible level, your insurance company won’t have to pay anything, and your claim will be denied.
Here’s an example: Say a storm knocks tree branches onto your roof, causing damage. The repairs are estimated to cost around $300, but your deductible is set to $500. That means your insurance company is not required to pay anything, leaving you to handle everything out of pocket.
Took Too Long to File
It’s important to note that homeowners’ insurance claims are time-sensitive and can not be filed whenever you please. Your insurance policy will likely have conditions that prevent you from filing a claim after a certain time frame. This is typically within a year of the date of loss, although some policies will allow you up to two years.
That’s why it’s so important to file claims immediately after a covered peril—failure to do so will cause your claim to be immediately denied, regardless of the extent of damages. In this instance, it’s rare that you would be able to appeal the denial.
Suspected Negligence
“Duty of care” is a legal obligation included in homeowners’ insurance policies. It requires policyholders to upkeep their property through regular maintenance and repairs so that it is in reasonably good condition and safe. Failure to do so is considered “negligence” and can cause your claim to be denied.
Let’s say, for example, you know that there’s a hole in your roof. You’ve been meaning to get it fixed, but keep putting it off until you find the right person to hire. If, during that time, a large storm comes through and causes water to enter through the hole in the roof and cause damage, your claim will likely be denied. Your failure to get the hole repaired in a timely manner violated your “duty of care”, and you are now the only one held financially responsible.
What to Do If Your Claim Has Been Denied
Just because your claim has been denied, that doesn’t mean that’s the end of it. You can always appeal a denied homeowner’s insurance claim—in fact, insurance companies are required to have an appeals process in place for these instances. While it will require more work, it’s worth it to receive the settlement you rightfully deserve.
1. Review Your Policy
One of the first things you want to do if your claim gets denied is understand why. Insurance companies are required to provide a written explanation detailing their denial decision—compare this to your policy, seeing where you went wrong within the coverage details and exclusions. Sometimes, simple misunderstandings can lead to denials, and all it takes is a closer look to resolve the issue.
2. Gather More Documentation
Although gathering proper documentation is something you went to get right the first time around, you may need to revisit this step (especially if it’s the reason for the denial). Go back over the photographs, written descriptions, repair estimates, and receipts you provided to your insurance company. You may need to gather new supporting evidence to strengthen your case.
3. Consider Hiring a Public Adjuster
In some instances, there may be a glaring detail you just keep missing. Unfortunately, your insurance company will not be the one to point this out or help you, and you may want to consider hiring a public adjuster. They’re insurance professionals who are well-versed in the complicated ins and outs of the claims process, and they may be able to uncover details you initially overlooked.
Contact Fortitude If Your Property Insurance Claim Has Been Denied
If you’ve experienced devastating property damage, only to have your claim get denied by your insurance company, you don’t have to navigate the process all on your own. At Fortitude Public Adjusters, we will fight on your behalf to get you a proper settlement.
Whether it involves combing through the fine print, gathering documentation, or making phone calls to your insurance company, we will do whatever it takes to make sure that you get the settlement you deserve. For a free consultation, contact us today!
