Merrimack Valley Home Explosions Lawyer

How to Ensure You Get Your Fire Insurance Claim

Insurance is meant to cover our losses in the event of an illness, injury or an event that destroys a home.  Regarding your house, you pay hundreds of dollars per year in premiums for fire, flood, or earthquake coverage or if someone is injured on your property. A fire is a devastating event that can wipe out not only your home’s structure but your photographs, mementoes, heirlooms as well as furniture, clothing, cars and other valuable property. When such an event does occur, we expect our insurance carrier to accurately assess the damage and pay us the full extent of our claimed loss. Unfortunately, insurers are not so ready to pay a loss if they suspect arson or some other event was the cause and is one that your policy will not cover.

Insurance companies do not always have your best interests in mind. After all, they are in the business of selling and collecting premiums and paying claims only if they feel your claim is totally valid and they have a good chance of having their denial of your claim upheld. But if your fire damage claim is denied, here are tips to fight your insurance company and give you a reasonable opportunity to get your claim paid:

  1. First, file the claim by calling your adjuster or agent. You will undoubtedly require temporary housing, clothing, food and other essential so ask for an advance on your claim.
  2. Prepare a detailed list of all that was lost or damaged. This includes clothing, furniture, kitchen and other appliances, food, tools from the garage, bicycles, televisions, computers, gaming devices and any other property.
  3. Make a video of the damage or at least photograph it extensively.
  4. If you have to vacate the property, be sure you secure it to prevent thefts and break-ins as any other damage or loss from your failure to do so will not be covered.
  5. Get a copy of your policy and review it for what is covered, the exclusions and the amount of coverage. It will contain conditions and timelines for filing your claim that you must follow. In some policies, you may have been required to have a home alarm system or security system in place. If you did, advise your adjuster and provide evidence that it was in working order.
  6. Be prepared to get estimates on repairing the damage if it is partial as well as cost estimates for appliances and furniture items damaged beyond repair.
  7. Smoke damage can be extensive and render property unusable. Some items may be repaired and others replaced though you may dispute an adjuster’s opinion over an item you feel should be replaced and not simply repaired.
  8. Have your HVAC system cleaned and paid for by the insurer or at least present it as part of your claim.
  9. Document each conversation with your agent or adjuster including date, time and substance of conversation, especially if you feel they are being hesitant about paying your claim.
  10. Cooperate with the insurer who will send an investigator to examine the property, determine the source and cause of the fire, assess your claimed damages and decide whether to pay or deny your claim or to pay only a portion of your claim.
  11. Consult with a lawyer who has handled fire damage claims before you give a statement to an investigator or adjuster since you may unwittingly make a statement that can undermine your claim and form the basis for an unjust denial.

If Your Claim is Denied

Fire insurance claims may be denied over errors made on a form or simply from lack of enough documentation that you are able to provide. The insurer, though, does have to offer an explanation for why your claim was denied.

If the reason was suspected arson or some fault of yours that the policy lists in its exclusion provisions, hire an independent investigator to undertake another investigation and prepare a written report if it is at odds with the insurer’s report and reason for denial. Your investigator should document that your home safety or fire alarm systems and smoke detectors were fully functioning and that your home was up to code. Once the report is complete, submit it for the insurer’s review. If it does not change their opinion, your policy will have provisions and instructions for filing an appeal.

Any time you have a claim denied, you should retain legal counsel who has experience with insurance claim denials and fire claims. Paul Tetzel is a Boston attorney who has successfully fought insurance companies over denials for damage claims related to fire and other covered causes for damages to homes and property.

Bad Faith Claims

Insurance companies owe you a duty or implied covenant to act in good faith, which means acting fairly. If it fails to do so, you may have a right to damages for breach of contract and under tort law principles. Examples of failing to act in good faith when denying a fire damage claim include:

  • Misrepresenting facts
  • Unreasonably delaying or failing to provide a reason for the denial
  • Failing to conduct an investigation or performing an inadequate one
  • Basing a denial on suspicion alone without either direct or substantial circumstantial evidence
  • Not attempting to settle your claim or to offer a reasonable settlement despite sufficient evidence justifying your damages
  • Misleading you on the statute of limitations or a policy provision
  • Threatening you if you advise them you are seeking legal counsel

These are just some examples of what insurers have done to unjustly deny legitimate claims or submit  low ball settlement offers to claimants. Call attorney Paul Tetzel if you are experiencing difficulties with your insurance company regarding your fire or other loss claim.