What to Do If Your Home Insurance Claim Is Denied

by Rowan Guthrie
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If your home has suffered damage due to an unforeseen disaster, you may expect your home insurance company to cover the repair and replacement costs.

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However, some home insurance claims are denied, leaving people like you with a financial burden and a lot of frustration.

Can Your Insurance Company Deny Your Claim?

Insurance companies can deny claims, but only for valid reasons. Your insurance policy is a contract between you and your insurer, and it specifies the terms and conditions of your coverage, as well as the exclusions and limitations. The company can deny your claim if:

  • Your policy doesn't cover the cause of the damage.
  • The damage is below your deductible.
  • The damage is deemed intentional or fraudulent.
  • You failed to comply with the policy requirements.
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What Are Some Reasons a Home Insurance Company May Deny Your Claim?

Some of the most common reasons home insurance claims are denied are:

  • Wear and tear: Your home insurance policy isn't meant to cover the normal deterioration of your home over time. Therefore, if the damage is due to aging, neglect or lack of maintenance, your claim will be denied.
  • Preexisting damage: Your home insurance policy only covers damage that occurs during the policy period. Your insurance claim will be denied if the damage was present before you bought the policy or renewed it.
  • Faulty construction or repairs: If the damage is due to poor workmanship, defective materials or improper installation, your claim will be denied. Your home insurance policy doesn’t cover the costs of fixing or replacing faulty or substandard work.
  • Code violations: Your claim will be denied if the damage is due to your home not meeting the local building codes or regulations. Your home insurance policy doesn’t cover the costs of bringing your home up to code or complying with the law.

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What Do You Do If Your Insurance Company Denies Your Claim?

If your insurance company denies your claim, you can challenge their decision and seek a fair settlement. Here are some steps you can take to dispute the denial.

  • Review your policy. Read your policy carefully and understand what it covers and excludes. Look for any clauses or endorsements that may apply to your situation.
  • Contact your insurance company. Contact your insurance company and ask for a written explanation of why it denied your claim. Explain why you disagree with the decision and provide evidence or documentation supporting your claim, and ask it to reconsider the decision or offer you a reasonable compromise.
  • File an appeal. This is usually a formal procedure where you submit a written request for a review of your claim by a higher authority within the company. You may have to provide additional information or evidence to support your appeal, so remember to keep a record of all your communications and correspondence with the company, as these may support your case.
  • File a complaint with your state’s insurance department. You can do this if your appeal is unsuccessful or you’re not satisfied with the outcome. This is a government agency that can investigate your complaint and mediate between you and your insurance company.
  • Hire a public adjuster. This professional will represent you and advocate for your interests in a home insurance claim, usually for a percentage of the settlement amount. They can help you assess the damage, estimate the repair costs, negotiate with your insurance company and handle the paperwork and documentation.
  • Hire an attorney. Choose one specializing in home insurance claims who can help you file a lawsuit against your insurance company and take them to court. The attorney can also help you prove your case, present evidence and argue your legal rights.

Can You Appeal a Denied Claim?

Yes, you can appeal a denied claim, but you must act quickly and follow the proper procedures. Your insurance company should provide you with the instructions and deadlines for filing an appeal. You should also consult with a professional, such as a public adjuster or an attorney, who can help you with the appeals process and increase your chances of success.

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