How to Appeal a Homeowner’s Insurance Claim Denial

There’s a saying that says, “knowledge is power.” This is especially true when it comes to homeowner’s insurance and what it covers.

There have been countless instances where homeowners were not compensated for losses. Most often, this is simply because they were unaware of what their policies provide. The financial impact of a denied claim can be devastating if a home is severely damaged during a catastrophic event.

Home insurance is one of the best means to protect your most expensive asset. Even still, there is a chance your claim could be denied.

Common Reasons a Homeowner’s Insurance Claim is Denied

  • Untimely filing – Taking too long to file can lead to denial. Make sure you are aware of your policy’s time-sensitive requirements for filing and documenting damage.
  • Late payments – Failure to pay your premiums on time could cause a lapse in coverage. If damage occurs during this lapse, you run the risk of the claim being denied.
  • Fraud – Insurance fraud is common. Anything that raises questions in the claim can trigger a denial. It is crucial to be detailed and accurate when submitting your claim. Provide photographs and videos of your damages from multiple angles with time stamps.
  • Uncovered claims – Read your policy. Know what is and isn’t covered. Are earthquakes, floods, tornadoes, or other regional risks covered? Add additional coverages to help fill the gaps.
  • Damage does not exceed the deductible – A home insurance deductible is what you pay before your insurance coverage kicks in. If the estimated damage or loss is below the deductible amount, the insurance company won’t pay the claim.

Roles of the Insurance Agent, Appraiser, and Commissioner

Speak first with your insurance agent or company after the denial. Ask if they require additional evidence or documentation. Don’t hesitate to ask them if there is a way to improve the claim to ensure its approval. For instance, a denial could be triggered by including only one photo of your damages. This might cause the company to think the claim is fraudulent.

independent appraiser evaluates roof damage for home insurance appeal

Next, the insurance company will assign an appraiser to your case. That appraiser’s job is to protect the insurer’s bottom line, not yours. Typically, you should hire an independent appraiser. That person will analyze the damage, verify what your policy covers, and determine an appropriate compensation amount based on all gathered facts.

Insurance commissioners are state-elected or appointed officials who function as mediators between policyholders and insurance companies. Insurance commissioners handle complaints filed against state insurance agencies and ensure insurance rules and laws are followed and carried out properly. They act as advocates to protect the rights of the people of their state against insurance companies.

Filing an Appeal

An appeal is a review of your previously denied home insurance claim. Be sure to stick to the timeframe for filing; you don’t want to miss the deadline.

Gather as much evidence and documentation as possible to support the approval of your appeal. Also, write a supporting document to strengthen your case and explain what occurred to cause the damage. Well-organized and comprehensive documents help give your appeal the chance of receiving more than a passing glance.

Insurance companies have millions of customers and quite frankly – even with their vast resources – want to pay as little as possible. To increase your odds of receiving a proper payout, be proactive. Read your policy, keep an inventory of items in your home, get extra coverage, and be particular about keeping records of damages.