According to the Insurance Services Office (ISO), only 6% of all insured homes had filed at least one claim in 2020, the majority of which are for property damage. As far as the remaining claims go, they have probably been denied.
Straightforward as they sound, denied claims are claims that have been rejected by insurance companies after looking at various factors and considerations. A claim cannot be easily re-submitted as soon as it has been denied, but most claims can be appealed. Whatever the reason for the denial is, one needs to ascertain it before appealing their claim.
The process of filing a claim can be time-consuming, overwhelming, and expensive, so to avoid denial from the onset, it’s important to collect as many clear supporting documents and records as possible to back up your claim. It is also critical to know the common reasons why insurance providers reject claims, the factors that they look into when deciding whether to approve or deny a claim, and how to avoid having your claim rejected.
Reasons Insurance Providers Deny Insurance Claims
Filing an insurance claim for property damage can be a challenging task. It becomes equally frustrating to find out that your insurer denied your claim. Here are some of the usual reasons why insurance companies would deny property insurance claims.
Untimely filing of the claim
There are time-sensitive actions required for the submission and support of every claim, so you need to inform your insurance provider as soon as possible of any losses.
Failure to pay premiums
As a policyholder, you are expected to pay your premiums on time. Any lapses or behind payments could result in your claim being denied.
Skeptical and false claims
You can expect that your insurance company would send one of their adjusters to look into your claim. They can reject your claim if they discover anything suspicious or dubious in the initial application for the coverage of losses.
Missing or incomplete documentation
It is your responsibility as a property owner to make sure all the damages done to your property are accounted for before you file and submit an insurance claim. Taking photos of the damage in the aftermath is recommended to support your claim. Otherwise, you will only be able to claim for damages with submitted proof, or your claim will be rejected altogether.
Exlusions clauses
There are exclusions in every property insurance policy. Your claim will likely be denied if your policy doesn’t cover the cause of the damage to your property.
Negligence to take preventative measures
It is also your responsibility as a policyholder to keep the damage to your property to a minimum, so that your losses are also minimal. The denial of the claim can be justified if you fail or neglect to take reasonable measures to limit the extent of the damages and losses.
Factors That Affect Approval or Denial of Claims
There are a few points that insurance companies consider when approving or rejecting insurance claims. Even if you have never had a home insurance claim denied before, it is vital to know about these factors in order to avoid the dreadful rejection.
Wear and Tear
Most insurance policies don’t approve claims for property damage due to wear and tear. This property damage occurs normally as part of aging, and the damage grows over time—even faster when preventive measures aren’t taken to mitigate them.
Vacancy
If a property has been empty, vacant, or uninhabited for more than a month and has suffered damage from fire, water, vandalism, or sinkhole during that timespan, the insurance provider may not pay the policy owner for the losses at all.
Breakdown of home equipment or appliances
A power surge may affect or break the internal parts of your appliances, such as TV or refrigerator. Your insurer may contest that the damages to such appliances are not covered in your homeowner’s insurance policy, so it helps to know and understand your policy.
Accidental Damage
If for example you put a hole in your roof or break your gutter by accident while doing something on top of it you may file for a claim if your property is covered by a building accidental damage insurance.
Damages done by pets
Insurance companies see pets as the responsibility of their owners. Therefore, they attribute any damage done by an animal to a property to its owner’s negligence, and so they usually deny claims for the repairs of such damages. On the other hand, you can use your policy to defend your property from damage by other pet owners’ animals.
Prevent Your Insurance Claims from Being Denied
Those unfamiliar with the specifics of a property claim specifics may find filing it time-consuming and challenging. Here are our tips for you to avoid dealing with denied claims.
- Be sure to notify your insurance provider of any losses as soon as possible, and be aware of the deadlines for submitting claims.
- Make timely premium payments.
- Find enough coverage if it’s available, and be aware of what your insurance covers and excludes.
- Take all necessary precautions to safeguard your property and control the extent of the damage after a loss.
- Document all the damages and submit a thorough, itemized claim to your insurance company.
Hire The Best Public Adjuster in Florida
It would be more advantageous on your end to work with professional public adjusters when filing a property damage insurance claim. An experienced public adjuster understands the ins and outs of an insurance policy, and can help you submit your claim, document the damages to your property, negotiate with your insurance provider, and keep your claim from being denied.
If you have trouble filing or submitting an insurance claim, or if you simply have questions, just call us today.
