Denied Insurance Claims

Denied Insurance Claims

After an unfortunate incident such as a fire or vandalism attack, most people rely on their insurance companies for help. It can, therefore, be heartbreaking when they deny your claim.

Reasons for Denial

Failure to File on Time

 It is a good idea to file a claim as soon as you can. If you wait too long, then your claim will be denied. Your right to file a claim starts o the day of the incident. Contact your insurance provider as soon as you realize that you have some property damaged. Different states and insurance companies have different policies regarding the amount of time you can wait to pursue a claim. Understand yours and act accordingly.

 Failure to Pay Premiums

 Your insurance company relies on premium payments to settle claims. If you do not make your payments on time, they may deny your claims.

 False Statements

 While it may be tempting to tell a few lies when filing your claim, it is not a good idea. Your insurance provider sends an insurance adjuster to determine the nature of your claim. They will look out for any suspicious activity and lies in your application for coverage. If it is determined that you were not truthful, your insurance provider is likely to deny your claim.

 Negligence on Your Part

 Your insurance company is supposed to cover you from unavoidable and unpredictable events. If they find out that your loss could be prevented by proper maintenance, your claims may be denied. Your claim may also be denied if you leave the property open to more damage after an incident. You are required to put in an effort to avoid additional damage to property.

 Failure to Document the Damage

 You should provide your insurance company with undeniable proof of damage. You can do this by taking detailed photos and videos of the damage. Police reports and witness accounts may also be useful. Insufficient documentation is a common mistake but it is easy to avoid.

 Exclusion Clauses

 You must understand the exclusion clause of your insurance policy before filing a claim. If your damage is excluded, your insurance provider will deny it.

How to Avoid Claim Denial

Keep detailed documentation of all damage
Notify your insurance company of loss or damage to property as soon as possible. Learn about the time limits of your insurer so you can file your claim on time.
Always make your premium payments on time
Observe proper care and maintenance of your property to avoid accidents. In case of damage, take the necessary steps to avoid further damage.
Hire a claims adjuster to help you navigate the process. If you are not familiar with the process, then they may help you avoid mistakes which often lead to denial.

What to Do In Case of a Claim Denial

If your claim for homeowners insurance has been denied, then you do not have to accept it. If you feel that the denial is unfair, you have the right to dispute it. Many insurance carriers are often unable to agree with their providers on the cost of damages. Since they are in business, insurance companies will always try to spend as little as possible in claims. Follow the following steps to dispute a claim denial and get sufficient compensation for damage to your home

Understand the Denial

If your claim is denied, you will receive a letter from your adjuster explaining that they have denied your claim and how they reached that decision. It is your right as a policyholder to receive formal notification. If you have not, you may b working with nothing more than speculation. If you have received a formal notification but do not understand it, you can ask your adjuster for an explanation. Their reason should match the details of your policy statement. The explanation may help you understand if the adjuster did not understand the nature of our situation. Some of the issues that may cause your claim to be denied include insufficient evidence, late filing, and filing errors. You can use this information when making an appeal.

If your insurance provider has sufficient reason to deny your claim, learn from t and avoid similar mistakes in the future.

We recommend contacting Shield Public Adjusters before dealing  with insurance companies adjusters. As licensed Public Adjusters we are ready to help at any time

 Contact Your Insurance Company

It is wise to contact your insurance company as soon as possible in case of a claim denial. You should, however, be careful not to contact them before you have all the necessary information. Gather as much evidence of the damage as you can. Your goal should be to have better evidence than you did when you first made the claim. If for example, your home suffered fire damage and you only submitted evidence of fire on one side, consider including more photos. Include detailed videos, receipts, and repair estimates from reputable contractors. Let them know about the estimate you received from your adjuster. If they give you any advice or instructions, listen to it respectfully and follow it.

Request them to consider reviewing your claim. Being as respectful and polite as possible is wise. Even though you may be frustrated, remember not to take your denial as a personal attack. It is, after all, the insurance adjuster and not insurance company that reviewed your claim. Mistakes happen, and your insurance company may get a different adjuster to assess your loss.

Hire An Public Adjuster

If your insurance company is unwilling to pay more, you may need to hire an Public Adjuster . They will give you a second professional opinion. Their new estimate may be in favor of or against the decision of your insurance company. It may affirm their judgment or help you convince them to change it.

Filing a complaint with the help of an attorney may help you get the compensation you deserve. The cost of an attorney is high, so you should only consider it when the amount of your claim is high enough. This option should only be used when everything else fails.

You may report unfair treatment or unethical business practices to your state insurance department. They will look into the matter and give you advice. If they feel that your complaint is justified, they will contact your insurance company and request for fair compensation on your behalf. If your state insurance advises you t hire an attorney, you should not expect them to help with the legal costs. Find a reputable attorney in your area. You may interview a few of them until you find one that will represent you in the best way at fair rates.

 Disputing Catastrophe Claims

Disputing catastrophe claims is similar to disputing other claims. It is, however, important for policyholders to make claims as soon and accurately as possible. Catastrophes usually have a big impact. They result in huge losses. Since the loses affect a wide location, insurance providers may have trouble managing the claims. For this reason, most insurance departments come up with specific dates for companies to acknowledge that a claim has been filed. Since they have limited time, most insurance adjusters will try to come up with estimates as soon as they can. In such cases, your adjuster may me back at a later date for a more detailed evaluation of the damage.

With insurance claims denial, prevention is always the best way to avoid problems. For this reason, it is wise to learn about the things that could lead to the denial of your claim. To avoid the denial of your next claim, ensure that you have sufficient evidence in the form of photographs and videos, file your claim on time, and fill out your claim accurately to avoid any errors. Getting the claims process out of your way as soon s possible may help you speed up the recovery process and put the unfortunate incident behind you.