When it comes to owning a home, one of the best things that you can do for yourself is to have a good insurance policy. In the case that your property is damaged, your insurance company can be your best friend. After discovering what has happened, you will be able to file a claim to get all repairs covered through a settlement check that is sent after proper inspection. However, this process, unfortunately, does not always go as planned. If your insurance claim is denied, it is beneficial to know what your options are and how you can go forth to retrieve the compensation that you deserve.
Being that your insurance company is supposed to be there to protect you as a homeowner, it can be frustrating to feel like they are ignoring you in your time of need.
It is important to understand that an insurance claim denial does not always mean that you have done something wrong as a homeowner. Although it is true that there is a lot of room for mistakes on your end during the claims process, chances are that you did nothing wrong. Either way, the following information will assist you in understanding how the claims process works, why your claim might have been denied, what you can do to help your case, and how you can prevent this from happening in the future.
How the Claims Process Works
If you experience any kind of home damage, whether it came from extreme weather and natural disasters or some other uncontrollable circumstance, one of the first things that you will need to do is file a claim with your home insurance company. Knowing this, you will need to understand precisely how the process works, to know exactly what to expect if you ever find yourself in a similar situation.
The process of filing a claim and receiving a settlement can seem complicated to someone who has never done it before, and the truth is that it can get tricky. There are multiple steps involved, and if you are not careful, you can miss out on the funds that you need to repair your home and rebuild your life.
That being said, the first step in making sure that your insurance claim does not get denied in the first place is understanding what to expect. That way, you will be able to go into it with an understanding of how things should play out. Below are the steps of the home insurance claims processed explained.
1. You Contact Your Home Insurance Company
As soon as you discover any kind of damage to your home, your first course of action should be to contact your home insurance company. This exchange can be done over the phone and will consist of your insurer getting the details of what happened, as well as any supporting evidence or documentation that you have to put toward your case.
2. An Adjuster Visits Your Property To Conduct an Inspection
After your insurance company has been notified of the damage, they will send one of their adjusters to your property. Once they get there at a scheduled time, they will conduct a walkthrough inspection of your entire home, assessing the damages and taking note of them.
3. The Investigation Begins
Following the inspection by an insurance adjuster, your insurance company will begin to look into the damages that you have claimed. During this process, which can take anywhere from weeks to months, they will decide how much money they are willing to give you for repairs if anything is necessary.
4. The Final Decision Is Made
Once the investigation is complete, your insurer will seal the deal by sending you a written letter outlining the outcome of your claim. This letter will let you know if you have won or lost the claim, and how much of a settlement you can expect at its closure. If you have won settlement money, you will receive a check in the mail shortly after, written out to your name.
What To Do When Your Insurance Claim Is Denied
While you can avoid a lot of mistakes by ensuring that you understand the claims process before filing one, mistakes do happen and you could still lose out on yours. After doing your due diligence to make sure that you have the possibility of receiving the settlement that you need, you might still find that your insurance company denied your claim completely.
In this case, you will need to know exactly what to do if it happens to you. 5 steps, in particular, will help you out in your time of need, giving you the possibility of still winning your claim, even after you received the letter of denial.
1. Review Your Home Insurance Policy
The very first thing that you should do after experiencing an insurance claim denial is to review your home insurance policy. As previously mentioned, the loss of an insurance claim is not always the fault of the homeowner.
In reality, there are a lot of technicalities within the average home insurance policy that many inexperienced homeowners will not be aware of before signing. As a result, certain damages might not be covered, even if they seem as if they should be.
The coverages included in your policy will always be outlined in writing, even if the language is not so clear. After facing a claim denial, you should go back and read over your insurance policy, doing so with an experienced agent who can decode it if necessary.
If you happen to find out that the damage you experienced was not actually outlined in your policy as a covered peril, you will be able to understand why your insurance company had to deny your claim. While there is very little that you can do going forward in this situation, you can begin to prepare yourself for next time to ensure that this will never happen again.
2. Look Over The Final Letter
Another thing that is crucial to understand in the event of a claim denial, aside from the specific coverages in your policy, is the reasoning behind why you were not granted the settlement check.
When your insurance company sends you the final letter stating the outcome of the claim that you filed, they are required by law to let you know exactly why they denied you. Going over this documentation again will help you to gain some insight into what you can do to switch it back into your favor if possible. If the language in your final letter is not as clear as you would like it to be, you can call a representative of your insurance company and ask them to explain it to you over the phone.
3. Collect Evidence and Documentation
If you find your insurance company’s reason for denial of your claim was flawed, you still have a chance to get what you need from them. The best way to get started in this scenario is to collect all of the evidence and documentation that you can.
This can include photo evidence of damages, written records of appraisals and inspections, and anything else that will prove what happened to your home.
4. Appeal Your Claim
If you find that your denial was not based on coverage limitations and you believe that your insurance company was wrong in their final decision, you will have the opportunity to appeal your claim. This will consist of reopening the claim that you lost and submitting a new argument in order to change the outcome into your favor. When taking this route, it is recommended that you have an experienced professional representing you for the best results.
5. Take Legal Action
While appealing your claim is always an option, there are certain scenarios where it can still prove to be ineffective. If you have exhausted all of the above techniques and you were still unable to retrieve your settlement, you might need to take legal action.
Legal action can include filing a complaint against your insurance company, which will go directly to the board of insurance. This is the best route to take when you feel as if your insurer has wrongly denied your claim or if any unethical practices occurred during the investigation of your claim.
If you are seeking compensation from your insurance company, you will get the best results by contacting an attorney. When the settlement itself is most important to you, this is the recommended course of action to retrieve your funds when you have no other options.
How To Avoid Home Insurance Claim Denial
In the event that your home insurance claim was denied this time and you weren’t able to retrieve the compensation that you were seeking, the best thing that you can do is to learn how you can avoid this problem in the future.
The tips explained down below will give you some helpful insight into what you can do before you enter into the claims process in order to guarantee the best possible results.
Make Necessary Changes To Your Existing Insurance Policy
As a homeowner, it is important to understand that every insurance policy is different. While the average policy will cover most disasters and perils that are commonly faced, it is necessary that you know exactly how you are covered by yours as opposed to just guessing.
Once you understand precisely what your insurance company will and will not pay for in the event of home damage, you can begin to prepare for the worst. If you complete this task before you are presented with a disaster, you will be able to make all of the necessary changes to protect yourself when something comes up.
While going over your insurance policy coverages in the fine print with your agent, you will be able to add services that will make you feel more comfortable and protected going forward.
Take Accurate Inventory Of Your Belongings (and Regularly Update It)
One of the first things that your insurance company will ask for after you file a home damage claim is evidence. Any kind of evidence that you have to support your claim will be the main reference during the investigation.
Knowing this information, you can’t go wrong keeping an accurate inventory of all of your belongings as they are before you experience any kind of peril.
The method that you use to establish your inventory is just as important as having it. While you could take paper photographs and keep receipts in your home, they will not hold up very well in the event of a natural disaster such as a hurricane or a wildfire.
To ensure that you can always access the photos and videos that you take of your belongings pre-disaster, it is recommended that you take and store them digitally instead. The best way to do this is to document them with your phone and save everything to a cloud. In the event that your home is damaged or completely destroyed, you can always access the records that you kept electronically.
Hire a Public Adjuster To Represent You
Last but not least, one of the best ways to protect yourself against denied claims as a homeowner is to hire a public adjuster. Public adjusters are professionals in the insurance agency and have extensive experience with filing claims.
Once you contact one, they will file the entire claim for you and facilitate all communication between you and your insurance company. While public adjusters cannot force settlement checks to be written for perils that are not covered by your insurance policy, it is safe to say that you will have the best possible outcome when working with a public adjuster, as opposed to going through the claims process all on your own.
The most beneficial time to hire a public adjuster is as soon as you discover any kind of damage. More specifically, you should reach out within 48 hours of finding out what happened to your home. To stay ahead of any potential issues with your property in the future, you can build a relationship with a trustworthy public adjuster before anything bad happens to your home.
