Insurance Claim Denied

Is Your Insurance Claim Denied?

The insurance claim process is complicated, especially when you have an insurance claim denied. In fact, 95% of insurance claims are either underpaid or wrongly denied. A licensed public adjuster is an expert at handling the insurance claim process and negotiating the maximum settlement that you are entitled to.

Common Reasons Insurance Claims Are Denied

Insurance companies deny claims for a variety of reasons, some legitimate and many questionable. Understanding why claims are denied can help you better prepare and protect your rights as a policyholder.

• Policy Exclusions: The insurance company claims the damage falls under a policy exclusion. However, many exclusions are applied incorrectly or too broadly.
• Late Reporting: Claims filed after the policy's reporting deadline may be denied, even if the delay was reasonable.
• Insufficient Documentation: Without proper documentation of the damage and its cause, insurers may deny the claim citing lack of evidence.
• Pre-existing Damage: Insurers may argue that the damage existed before the covered event, even when it clearly did not.
• Lowball Valuations: While not technically a denial, offering far less than the actual value of the claim is a common tactic that effectively denies policyholders their rightful compensation.

What You Can Do About a Denied Claim

If your insurance claim has been denied, you have several options:

1. Review Your Policy: Carefully review your insurance policy to understand your coverage and the basis for the denial.
2. Request a Written Explanation: Ask your insurance company for a detailed written explanation of why your claim was denied.
3. Hire a Licensed Public Adjuster: A public adjuster works for you, not the insurance company. They can review your claim, gather additional evidence, and negotiate on your behalf.
4. File a Complaint: If you believe your claim was wrongfully denied, you can file a complaint with your state's Department of Insurance.
5. Invoke the Appraisal Clause: If the dispute is about the value of your loss, most policies include an appraisal clause that allows for independent valuation.

The Role of a Licensed Public Adjuster

A licensed public adjuster is an expert at handling the insurance claim process. Unlike insurance company adjusters who work for the insurer, public adjusters work exclusively for the policyholder. They understand the complexities of insurance policies, know how to properly document losses, and have experience negotiating with insurance companies to maximize settlements.