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What To Do if Your Home Insurance Claim Is Denied

A home is often your most significant investment and greatest asset. However, homeownership creates a substantial amount of risk. Most property owners acquire home insurance to protect them in the event of property damage. But not all insurance carriers play nice.

An accident can damage or destroy your home. An injury occurring on the premises can leave you liable for damages. What can you do if your home insurance claim is denied?

This article addresses some essential considerations following a home insurance claim denial. The article discusses:

  • Why an insurer might deny your claim
  • The importance of reviewing your insurance policy documents

It also addresses your options if your property damage claim is denied in bad faith.

Why Was Your Property Insurance Claim Denied?

The reason for denying a home insurance claim is significant when determining your options. Insurers may refuse your claim if:

  • Your insurance policy doesn't cover the particular type of damage
  • The damage occurred outside of the insurance coverage period
  • You failed to meet a condition of coverage, such as demonstrating proof of loss

If your insurance provider denies your claim, you should receive a formal denial letter. The insurer's denial isn't the end of the story, though. Suppose the denial is based on a misunderstanding of the facts. In that case, you may be able to resolve the matter by sending a response to the denial, along with evidence supporting your position.

Most of the reasons for a home insurance claim denial relate to the insurance policy itself. That's why it's so important to closely examine your agreement to determine whether there's a basis for denying your claim. Understanding the terms of your contract will direct both your initial response to a denial as well as provide focus for any subsequent lawsuit.

Review Your Home Insurance Policy Documents

Suppose your response to your home insurance claim denial fails to change the insurance adjuster's decision. In that case, you may need to file a lawsuit to recover damages as a policyholder. This means showing how the insurer breached their agreement to pay you for your loss in case of a covered accident. Your homeowner's insurance policy establishes the scope and period of the coverage, so it's an essential document for formulating an appeal or response.

Pay particular attention to your insurance policy's exclusion clause. This part of the document indicates what events the insurer doesn't cover under a standard policy. Insurers frequently exclude natural disasters like earthquakes or flooding under standard home insurance policies. In the insurance industry, you, as the insured, have to add coverage for these events. Additional types of coverage, such as those for flooding and water damage, can increase your insurance rate or premium.

Contact Your Insurer

If your claim has been denied, reaching out to your insurer may help you better understand what information might help your claim. Stay calm and speak respectfully to the insurance representative or claims adjuster. Inquire about the insurer's perspective of the facts and the claims process.

You can also inquire about the appeal process to determine the next steps you can take following an insurance claim denial.

Contact Your State Insurance Department

Every state has a regulatory body that provides governmental oversight to insurance carriers. If your insurer refuses a homeowners insurance claim settlement, you can report them. Your state's department of insurance may conduct an independent appraisal of the situation. If your insurance company has failed in bad faith to make a settlement offer, they may help you obtain a payout. For example, in Florida, the Division of Insurance Agent and Agency Services may handle such cases.

Bad Faith Denials and Causes of Action

Insurers are required to act in good faith when reviewing claims for insurance benefits. An insurer who seeks to avoid their obligation to pay a legitimate claim has made a bad-faith insurance denial. Some states provide a statutory or common law right to sue for denied claims made in bad faith. You can also bring an action for breach of contract, claiming the insurer failed to adhere to their end of the insurance agreement.

If you're successful with your lawsuit, you may be able to recover your attorney's fees. You may also be awarded punitive damages. Punitive damages aim to deter a defendant from bad behavior in the future.

Get Help With Your Insurance Claim Dispute

If your home insurance claim has been denied, it may be difficult to determine whether to file a lawsuit against your insurance company. Contact an insurance attorney with years of experience to learn more. They can give you disclaimers on how to protect your valuable real estate and better understand insurance laws.

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