If you were expecting to be able to make a claim on your home insurance, only to receive a denial letter in the mail, it can be shocking and frustrating. You know you need that money to fix whatever problem you had, but you don’t know what your next step should be. It’s natural to feel frustrated and confused at this point, so here are some suggestions of what you can do if you receive a home insurance claim denial letter.
Start with your agent
If you’re reading this and your home insurance claim denial letter just arrived, we know it may seem discouraging. But there are things you can do! In order to file an appeal, you’ll need the following information: a copy of the denial letter, written statements by all claimants including property owners and occupants describing how they were harmed by the loss or what services they cannot use because of the loss (e.g., housekeepers), property repair estimates with proof of coverage/proof of payment for repairs and occupancy costs during period of denial and repair work order, contractor’s invoice (including date ordered and date completed) with company ID number that matches form W-9 on insurer’s list. This sounds like a lot of information, but most insurers will help you get it together. The last thing is to make sure that the home insurance claim denial letter is in your hands before you go ahead and start working on everything else. If not, contact your agent immediately to see if they mailed it out or if it was lost in transit.
After doing some research I found out about filing claims through small claims court which seems more within my abilities as a homeowner but would appreciate any feedback on the matter
Contact the company in writing
If you receive a home insurance claim denial letter from your insurance company, it is likely because the insurer is not willing to pay for the damages you are claiming. They are able to deny these claims by arguing that the following might be true: 1) there is not enough evidence that proves the damage was caused by an accident or intentional act, 2) even if it was caused by an accident or intentional act, there was no coverage in place or 3) even if there was coverage in place, they do not feel like they owe money due to contract language stating they owe money only if certain conditions were met. The best way to deal with these denial letters is usually to contact the company in writing. If you want them to reconsider their decision, then try and provide more information about the situation. If this does not work, then hiring a lawyer may be necessary. A lawyer can help argue that you have a valid case and should be paid. There are some cases where the law requires an insurance company to pay out on a claim, so consulting with an attorney could help make sure your case falls under one of those categories. If not, then it will depend on whether the judge finds that you have provided sufficient evidence of negligence.
Get help from the media
Do not panic if you get denied for your home insurance claim denial letter. These types of cases happen all the time, and there are steps you can take to ensure your home is properly covered. The first thing you need to do is figure out the denial code that was given by the insurance company, which will allow you to understand the specific reason for denial. For example, one type of denial code means that something was not disclosed when the plan was taken out, while another could mean your deductible has expired. Once you have this information on hand, you can take it into consideration and revise your coverage accordingly in order for it to be approved. Take pictures of any damage caused as well so you have them as proof and save copies of your correspondence with the insurer so you know what was said. It’s also important to mention that your policy should cover disasters such as fire, windstorm or hail storm, which are common reasons for denying claims. Additionally, make sure you review the policy before taking it out and read through everything carefully so you’re aware of what they’ll pay or not pay in the event of a disaster. One way to protect you from being denied is having an emergency fund ready to use should disaster strike. It might seem like an expensive idea at first glance but at least then you won’t be scrambling looking for cash and potentially delaying repair work because you don’t have money saved up.
Seek legal advice
Most denial letters will list reasons for the refusal and tell you about your next steps. Some of these reasons are in-your-favor, so be sure to read through them carefully. For example, the denial letter may say something like this coverage is excluded under Section B on our exclusions list. In this case, you will want to look at the sections related to fire and explosions (Section B) and see if your claim falls into one of those categories. If it does not, then you will want to determine whether or not there is another exclusion that applies and decide how best to proceed. One last thing to keep in mind when you receive a denial letter: make sure to document any conversations with the company’s customer service representatives. Sometimes they can provide valuable information about why your claim was denied even if it is not explicitly stated in the home insurance claim denial letter. Documentation is important because if you need to go further than just making a phone call, having documentation helps prove that the company has made an incorrect decision. If you cannot get a satisfactory answer from their customer service department, I recommend filing a complaint with the Department of Insurance in your state as well as consulting with an attorney to discuss what options are available to you.
