Tips For Dealing With Denied Claims

Posted October 14th, 2010
by HomeownersInsurance.org Staff (no comments)

Whenever you submit a claim against your homeowners insurance policy, your insurer could deny it. Dealing with denied claims can be frustrating, confusing, even frightening, but you don’t have to take no for an answer. While in many cases denied claims are simple errors or miscommunications, a claims denial could also represent fraud. If you think you’re not getting what you paid for, don’t let the matter rest until you’ve gotten to the bottom of things.

  1. Review the denial. When the insurance company denies your claim, they should provide a reason. Make sure you understand their rationale.
  2. Certain types of claims and damages may be excluded from your policy. For example, many insurers exclude dog bites or provide only limited coverage, and flood damage is typically not covered by a standard homeowners policy. Instead, flood insurance is sold separately. Always review your policy to make sure the damage in question is covered.
  3. There may be policy maximums on certain types of claims. If your claim exceeds the amount of coverage, you may only be eligible for partial reimbursement of your loss. Verify your coverage amounts in your original policy document.
  4. If you believe your claim should be covered after reviewing your policy, you can appeal your denial with the insurer directly. Making an appeal is no guarantee of payment, but if you don’t appeal, the denial will be the final word. Appeal the decision in writing, and keep a copy of any paperwork you submit.
  5. Be sure to gather evidence in support of your claim. Take photos, get estimates for repair work, and have documentation of medical bills, when appropriate. Keep a copy for yourself, and provide one copy to your insurer.
  6. Follow up on a regular basis to track the status of your appeal. Be sure you know who you are talking to when you call, and keep notes of the conversation.
  7. If the insurer refuses to resolve the issue in a fair and appropriate manner, you do have recourse. You can hire an attorney to represent you in a lawsuit against the insurance company. Just be sure you have everything documented to provide evidence to the court. Even if you aren’t awarded the full amount of your claim, you are more likely to get a fair deal if you raise concerns than if you simply take no for an answer.

Negotiating for what’s fair and documenting the facts as they take place are always good skills to have at hand. You will be sure to have evidence to back up your side of the story in any claims dispute, you could easily affect the outcome if you’ve done your homework.

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