If you’ve recently submitted a home insurance claim and have been denied, you may be wondering why the claim was denied and what you can do about it. Unfortunately, the process of filing and submitting home insurance claims can be confusing, so you should know up front that most claims are denied in some way or another. There are plenty of reasons why your home insurance claim may be denied, so to help you figure out what went wrong, we’ve compiled this list of the top five reasons why home insurance claims are denied!
1) We can’t find your policy
If you’re wondering why your home insurance claim was denied, the first place to look is your policy. If you can’t find your policy, it may be because you lost it or because the insurance company cancelled it. If that’s the case, you’ll need to contact your agent to get a new one. There are a few other reasons why your home insurance claim may be denied, such as if you filed a claim for something that’s not covered by your policy or if you didn’t file the claim within the time frame specified in your policy. If you’re still not sure why your home insurance claim was denied, contact your insurer and they should be able to give you more information. If your coverage was denied because of misrepresentation, a fire claim denial letter will include details about what type of property damage isn’t covered and how long the exclusions will last.
For example, if you had an earthquake with no visible structural damage, but incurred expenses related to water cleanup from burst pipes on inside walls, these items would not be covered by an earthquake-specific policy. It is important to keep receipts for these types of damages until you know whether your coverage will be reinstated or extended past its current expiration date.
While many homeowners mistakenly think their hurricane deductibles are waived after their state has been declared disaster area eligible for FEMA relief funding, those deductibles still apply so make sure you have the funds available when filing your claim with your insurer.
2) You Didn’t Call Us Immediately
If you don’t call your insurance company right away, they may deny your claim. They could argue that you didn’t give them a chance to inspect the damage and that it may have been caused by something other than what you’re claiming. If you have a water leak, for example, and you don’t call us until a week later, we may deny your claim because the damage could have been caused by a number of things and we can’t be sure it was from the original event. Your Adjuster Didn’t Show Up: Did you know some insurance companies will wait up to 10 days before sending an adjuster out? If so, if your claim falls within those 10 days and there’s no evidence of how or when the incident occurred, we may not pay out on your claim.
You Waited Too Long To Make The Damage Known: Some homeowners think that as long as their property is insured against fire or theft then everything else will fall into place – unfortunately this isn’t always true. We need time in order to investigate claims and most companies only offer a limited amount of time for any repairs or replacements. That’s why waiting too long before filing a report can result in denial.
3) Your Report Has No Details
Make sure to include as many details as possible when filing a claim, including photos of the damage and the surrounding area. Some companies may also require you submit an itemized list of all items damaged in order to process your claim. Additionally, if it is a crime-related event such as vandalism or theft, some insurers will deny the claim because they deem it to be too high risk.
4) You Aren’t Covered For This Kind Of Damage
Your home insurance policy is a contract. In that contract, there are certain perils, or risks, that are covered and certain ones that are excluded. Most policies exclude coverage for damage caused by floods and earthquakes, for example. If your home is damaged by one of these excluded perils, your claim will likely be denied. The following reasons also may result in a denial:
You Need To Report The Damage To The Insurer Immediately: Once you learn about the loss, you have to tell the insurer as soon as possible. The insurer may ask for pictures of the damage or documentation from an appraiser before accepting responsibility for damages. If you don’t notify them within 60 days after the loss, your claim may be denied on grounds that it’s not timely filed.
You Didn’t Meet State Requirements For Notifying Authorities And/or Maintaining Records: All states require homeowners to notify authorities when their property has been damaged and to maintain records of all expenses related to the repair. Some states also require homeowners to take additional steps before filing a claim with their insurer.
5) We Can’t Afford To Pay Out Right Now
1. Your home insurance policy has a replacement cost clause. This means that in order for your claim to be paid out, the damages to your home must exceed the replacement cost of your home. If the damage to your home is less than the replacement cost, your claim will be denied.
2. You have a pre-existing condition. Most home insurance policies have a clause that excludes coverage for pre-existing conditions. This means that if you have a condition that existed before you purchased your policy, your claim may be denied.
3. The cause of the damage is not covered by your policy. Home insurance policies typically exclude coverage for certain types of damage, such as flood damage or earthquake damage. Check with your insurance company about which causes of damage are excluded from coverage so you can make sure that your home is insured against those types of disasters.
4. Your deductible does not cover the total cost of the repairs needed to fix your home. For example, let’s say you have a $500 deductible and there was $1000 worth of damages done to your roof because it was hit by lightning. Your claim would be denied because it does not meet the threshold for what would be covered under your deductible amount ($500).
5. Damage done during an excluded period on days other than Sundays and Holidays is not eligible for reimbursement under most plans either. In Florida, this time period starts on June 10th and ends on September 8th every year.
