Having your home or belongings destroyed or damaged by a fire, storm, or other disaster can be a traumatic experience. It can be even worse if your insurance company refuses to pay to repair or replace your property. Although insurance companies are difficult to fight, you have rights. Here’s what to do if your homeowners insurance claim is denied.
How do I appeal an insurance claim denial?
The first thing you should do if the insurance company denies your claim is review the denial letter. The insurance company is required to specify in writing the reasons for denying your claim. If the insurance company’s rationale is based on inaccurate information, you have the following recourse options:
Reading: How to fight home insurance claims
Contact the insurance company. If you have documents, photos, or other evidence that refutes the insurance company’s reasons for denying your claim, please present this information to the insurance company’s claims representative or manager. insurance company. it can usually start with a phone call. you can even email digital copies of your documents while you’re online.
File a complaint with your state insurance commissioner. Insurance companies and agents must cooperate with the insurance commissioner’s investigation of consumer complaints. any supporting documents and photos you can provide will strengthen your case.
Consider mediation. Some states offer free mediation programs to resolve disputes over insurance claims. You and a representative from the insurance company discuss the claim with a neutral mediator who facilitates a non-binding resolution, if possible. You do not need to bring an attorney to mediation, but you may.
Eligibility thresholds vary by state. In Florida, you can submit a claim of more than $500 to mediation. California only offers mediation for declared emergency claims over $7,500.
Consider taking legal action. Due to the time and expense that lawsuits require, suing the insurance company is often considered the last resort to dispute a claim.
why would an insurance company deny a claim?
Generally, your claim can only be denied if the cause of the damage is not covered by the policy or if you fail to meet your contractual obligations. These are some of the most common reasons an insurance company denies a claim.
missed the submission deadline
Your policy specifies the amount of time you have to file a claim after a loss or damage occurs. This is a deadline not to be missed.
non-payment of the premium
If you fall behind in payments, the insurance company must notify you in writing of a pending cancellation and the deadline to submit your reinstatement fee. coverage generally expires if you don’t submit your payment by the end of the reinstatement period.
Unless you can prove that the insurance company mishandled your payment or failed to provide required notice, this is a difficult question to appeal.
If the adjuster inspecting your home finds conditions that are different from those stated on your claim form or application, your claim could be in jeopardy.
If you’re claiming your state-of-the-art entertainment components or luxury kitchenware were destroyed or stolen, the insurance company will probably want to see receipts or other documentation of their value.
Best practice is to keep a home inventory, listing your possessions in as much detail as possible. include brand and model names, dates of purchase and, where available, also receipts and serial numbers.
damages for cause excluded
A typical homeowners policy does not cover floods, earthquakes, sinkholes and other excluded perils. knowing what is covered in advance is better than finding out what is not covered after your claim is denied. never hesitate to ask your agent about your coverage.
unrevealed buff damage
If you don’t tell your insurance company about renovations and additions to your home, any damage to your home probably won’t be covered by your insurance policy. Inform your insurance agent about home improvements as soon as they are completed.
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An insurance policy generally requires you to maintain your property with reasonable care. An insurance company might claim that your negligence caused, for example, a break in your water heater or plumbing system. to deny your claim. keep receipts and other records of maintenance work done by you or your contractors.
professionals to help you dispute an insurance claim denial
For help disputing your insurance claim denial, consider hiring a public insurance claims adjuster or attorney. You can hire one of these professionals at any point in the claims process. this is how everyone can help.
Public Adjusters are licensed insurance professionals you can hire to prepare your claim or appeal a claim settlement on your behalf. Public adjusters will usually review your policy and help you gather the documentation you need before you file a claim or if you need to appeal a denied claim. Public adjusters can also dispute a claims settlement that you believe is too low.
Many offer a free initial consultation and accept a percentage of your settlement, usually 5-20%, as payment. If your claim has already been denied, the consultation and payment method can protect you from high upfront costs while you get a professional opinion about your chances of success on appeal.
A public adjuster must be licensed in your state, and a license from the National Association of Public Insurance Adjusters is even better.
A typical attorney is going to be considerably more expensive than a public insurance adjuster. You do not have to wait until you are ready to file a lawsuit to hire an attorney. Attorneys are expensive, but insurance company claims representatives will pay close attention to the details of your claim when your attorney inquires about them.
When looking for an attorney, look for one who specializes in insurance law with a track record of successfully obtaining results for homeowners.
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