Tips For Reviewing Home Insurance Claim Denial

If your home suffered damage from a fire, flood, burglary or other disaster, you expect your homeowner’s policy to cover your losses. Imagine the shock when you receive a denial letter and you are left with an uninhabitable home or must come up with thousands of dollars to repair, replace or restore the home and other property that was lost.

There are many reasons for a home insurance claim denial. Most pertain to the lack of coverage, such as for flood damage where the policy states it does not cover such losses. If a fire damaged your home, the policy might have required you to have a smoke alarm installed in the area where the fire emanated. Other exclusions might be for failure to pay the premiums on time or because you did not provide some documentation that is easily obtainable. In some cases, the insurer may allege that you did not timely file your claim.

Still, insurance companies will deny claims on dubious grounds or underpay for damages whenever the opportunity arises. If your home insurance claim is denied, here are some home insurance denial tips for you to consider:

  1. Review your policy regarding conditions that are not covered and for the maximum coverage amounts, which may be less than your damages. Some denials are based on what the insurer interprets as a condition for which there is no coverage.
  2. Call the adjuster and discuss the reasons for the denial. Be sure the agent refers to the applicable provision. If you do not accept the denial, document the substance of the conversation and confirm it with the agent in a letter and keep a copy. If an email, print it out and retain it with your records.
  3. Consider retaining your own investigator if you dispute the claimed cause such as arson or flooding or other condition presumably not covered.
  4. Take videos and photographs of the damage.
  5. Get estimates for repair or replacement of appliances, cars or furniture.
  6. Follow through with the appeal. Though it is a process handled internally by the insurer, you should provide as much documentation as possible to support your case. If the claim denial is sustained, you will have a better case for proving bad faith if the reason is unjustified or contrary to the evidence.

Bad Faith Denial

Insurers are required to promptly respond to claims, to conduct thorough investigations if they suspect fraud or a not covered condition and to clearly state the basis for a denial. An insurer can be held liable for a bad faith denial of a claim under the following circumstances, among many others:

  • Failure to investigate
  • Conducting a minimal investigation
  • Providing no clear reason for a denial
  • Threatening an insured
  • Disregarding or deliberately misconstruing evidence that clearly contradicts their position
  • Misrepresenting the meaning of a provision
  • Making unreasonably low settlement offers
  • Making the insured provide unnecessary documentation
  • Unreasonably delaying payment

If you have experienced any of these, contact an attorney who handles bad faith insurance claims so you can get your losses paid. Damages for a bad faith insurance claim include:

  • Payment under homeowner’s policy for any covered losses unreasonably denied
  • Attorney’s fees
  • Interest on previously denied compensation
  • Possible double or triple damages

Paul Tetzel is a Boston attorney who handles bad faith denials of insurance claims. Get home insurance claim denial help by calling his office today to discuss your possible bad faith claim.