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Your homeowners insurance coverage is supposed to provide reliable protection if your home gets damaged by forces beyond your control. When an insurer denies your claim, it can leave you feeling vulnerable and out of options.
If you’re questioning your claim denial and want to get down to the bottom of things, you can always dispute it. Home insurance carriers do make mistakes at times and you can negotiate with them depending on your policy terms and the type of damage to your home.
Here’s how to dispute an insurance claim denial:
How to dispute a home insurance claim denial
If your home insurance claim is denied, the first thing you’ll want to do is find out why. The home insurance carrier will send you a formal letter denying your claim and disclose the reason why. Carefully review this letter and compare their reasoning to your policy details to see if everything matches up.
Sometimes insurers deny home insurance claims for legitimate reasons, like the type of peril you listed not being covered in your policy, or a lapse in coverage due to unpaid premiums.
However, if you think your homeowners insurance company should have covered your claim, you have a few ways to dispute it. Start the process by closely reviewing your coverage and initial claim. As you gather all your supporting documents and photos, consider options such as calling the insurance provider, setting up mediation, or even contacting your state’s insurance department.
1. Contact the insurance provider
Disputing your claim denial with the actual insurance provider is a great place to start. This may seem intimidating if it sounds like their decision was firm. Still, if you find any discrepancies in the policy that make you question the denial, it’s worth reaching out.
Ask to speak to someone higher up, such as the claims manager, to discuss your concerns. It’s a good idea to have all your photos and supporting documents (like damage reports from third-party experts and estimates) on hand to further prove your case.
You’ll need to provide this information anyway if you decide to file an appeal and request that an insurance adjuster review the claim. Check with your insurance carrier to see what the time frame is to file an appeal.
2. Consider mediation
Mediation is when an impartial third party comes in to help you, as the homeowner, and the insurance carrier come to a mutual agreement. Your state’s Department of Insurance may be able to provide a mediation program to discuss disputes over claims, and some of these mediators are free.
The mediator could also be court-appointed or a private, professional mediator that both parties agree on. Make sure your mediator has no incentive to favor one particular side and is completely impartial. Asking your mediator about their prior experience with litigating and resolving insurance claim issues can be helpful, too.
Your insurance policy may include details about mediation, including how the costs will be covered. Sometimes the insurance provider splits the cost with the policyholder, but this is not always the case. Also, mediation is not legally binding, and you can choose to bring legal representation with you if you feel you need additional support.
3. File a formal complaint with the state
Another way to dispute a homeowners insurance claim denial is to file a formal complaint with your state’s Department of Insurance. While state insurance department employees can’t represent you in any legal proceedings, they can help investigate your case if you file a complaint.
You can typically file a complaint online or by mail. When you submit a complaint, make sure you include all your supporting documents and photos to clearly communicate your position.
How to avoid getting your insurance claim denied
One of the main reasons why a homeowners insurance claim might be denied is if the type of damage is not covered by your policy. This could include incidents such as floods or earthquakes, depending on your coverage Luckily, you can prevent insurance claim denial in a few simple ways.
Here’s how to avoid having your insurance claim denied:
- Pay premiums on time. It’s important to make sure your insurance premiums are paid on time to avoid a lapse in coverage. If you have a mortgage, your homeowners insurance payments may be paid automatically each month when you make your house payment.
- Don’t miss the claim deadline. Sometimes, there’s a fixed window of time to submit your claim after damage occurs to your home. Even if you’re rightfully deserving of an insurance payment, your claim could get denied if you don’t submit a claim in a timely manner.
- Submit clear and thorough documentation. Too many details and information about an incident is hardly a bad thing when submitting an insurance claim. Make sure you provide sufficient documentation, photos, and assessments to prove that your claim is valid. If your insurance carrier replies with a question or request for more information, try to respond promptly.
- Disclose all home additions to your insurance provider. If you’ve added an addition to your home or changed the structure itself, you need to let your insurance provider know — if it increases your home’s value, your current insurance limits may no longer be enough. If you don’t inform your carrier and that addition gets damaged, your insurance company may deny your claim, so be sure to let your agent know as soon as you make changes like these.
- Don’t neglect maintenance. Home insurance typically doesn’t cover damage that results from you not taking proper care of your home. If a storm comes in and destroys your roof, your insurance company may provide the money to repair your home. But if an inspector notices that your roof was in extremely bad shape due to a lack of maintenance, you may have issues getting your claim approved. It’s a good idea to keep track of your receipts to establish a paper trail of the routine maintenance work you’re having done.
A denied homeowners insurance claim can leave you feeling uncertain about your coverage and any home repairs. One of your first courses of action should be to dispute the denied claim. Now that you know how to dispute an insurance claim denial should you ever need to, be sure to review your existing homeowners insurance policy to get clear on your coverage.
This could be the perfect time to consider any exclusions or coverage gaps and shop around for a new insurer. Credible makes it easy to compare homeowners insurance rates from multiple carriers.