A hurricane has ripped the siding and roof off of your home. Yet, as harrowing as the event was, you are content that at least the damage will be covered by your insurer. So imagine your surprise when your insurance company lets you know they have denied your claim. All of a sudden, you are wondering how you will be able to afford to make repairs or if you will even be able to stay in your home.
Unfortunately, this is not an entirely uncommon scenario. Below is a look inside property damage insurance claim denials. This post details what a property damage insurance claim denial is, why it happens, and what you can do about it.
What is a Claim Denial?
A claim denial occurs when an insurance company investigates a claim and determines there is no coverage to pay the claim.
An insurance adjuster will first assess whether there was damage and what was damaged. Then, he or she must decide whether the event caused the damage and whether the damaged property is covered under the policy. If both the property damage and the cause of the damage are included in the policy, then the insurance company must calculate how much it will pay out.
Sometimes, an insurer will pay you exactly what is owed. Other times, they will offer less than the claim you submitted. Finally, the insurer may deny paying the claim outright.
Some Reasons Claims are Denied
Here are some common reasons that claims get denied.
Insufficient Documentation
Claims come with a whole lot of paperwork. You will have to submit a lot of documentation and papers and do everything timely. If you fail to do so, your claim may be delayed or even denied.
Policy Lapsed
Everything seems to be on autopay these days, and we just assume bill payments are drawing. Unfortunately, this is not always the case. If you have not paid the premium and an incident happens, you may be in a precarious situation. Sometimes, insurance companies have a grace period. However, the insurance company may not need to pay for damages if you are outside that grace period.
Exclusions
An exclusion is something that an insurance policy does not cover. These are typically spelled out in the contract. For instance, the homeowner’s insurance policy may cover your house but no unattached buildings. Therefore, any damage that happens to an unattached garage may not be covered.
Bad Faith Denial
There are also times when insurance companies improperly deny claims, fail to issue claim payments that are owed or fail to act fairly. When an insurance company does not act in compliance with Florida law, it can be subject to a bad faith suit.
What’s Next if My Claim is Denied?
Fortunately, you do not need to simply accept that your claim has been denied. Here are some steps you can consider taking to challenge the denial.
Keep Good Notes
Keep great documentation. Document everything: letters to the insurance company, phone calls, and emails. Put communication in writing if at all possible, and use certified mail if sending it through the mail.
Take photos. Preferably, take pictures of the insured property before you file a claim so they have something to compare the damage to after the incident. When safe to do so, get photos of the affected areas.
Contact Your Insurance Company Right Away
Contact your insurance provider when you receive notification that your claim was denied. Ask them the reason for the denial. This will help you determine whether the reason for the denial was legitimate or illegitimate. If the reason was not legitimate– such as the coverage was clearly included in your policy – it is time to find a seasoned insurance attorney. However, if there was a legitimate reason for the denial, this does not mean your claim will automatically fail. There could be an easy way to reverse the denial, such as by providing additional documentation to your insurer.
Consider an Independent Adjuster
An independent adjuster is not employed by the insurance company. He or she will review the damage and your claim. They will review your situation and then give their opinion about how much money you are owed. This is not a free service but it can be very valuable.
Contact the Florida Office of Insurance Regulation
This office oversees everything related to insurance in the state. If you feel that you have been unfairly treated or that the insurer has returned with a low figure despite knowing they must pay more, you may have grounds to file a complaint with the office.
Hire An Attorney
If you cannot get anywhere with the insurance company on your own, it may be time to hire an attorney with experience dealing with claim denials. It can be frustrating and scary when a property insurance claim is denied. However, experienced property insurance attorneys can help walk you through the process and secure the money you deserve.
Speak to an Insurance Attorney
Contact our office today at 321-415-9012 to speak with one of our homeowners’ insurance attorneys if you would like to discuss the particulars of your situation. We present the material contained on our website and pages, including this Blog, for general informational purposes only. It does not constitute the rendering of legal advice and does not create any attorney-client relationship. If you need legal or other professional advice, you should consult with legal counsel about your particular facts and circumstances. Contact us to see how we may be able to fight for you!