What do I do if my insurance claim is denied?

Experiencing damage to your home is distressing enough, but what if your homeowner's insurance claim is denied? This can be disheartening, but it's not the end of the road. In this blog post, we'll guide you through the crucial steps to take when facing a claim denial, ensuring you understand your options and rights in the process.

Understand the Denial

Your first reaction to a denied claim may be shock and frustration, but it's essential to remain calm and focused. The denial letter from your insurance company should outline the specific reason for the rejection. This reason could range from insufficient evidence to a policy exclusion. Understanding the cause of the denial is your initial key to finding a solution.

Review Your Policy

After reviewing the denial, take the time to dive into the details of your homeowner's insurance policy. Policies can be complex, and each one is unique. Pay close attention to sections related to the type of damage or loss you've experienced, as well as any deductibles and coverage limits. Understanding the intricacies of your policy is paramount in determining whether the denial is justified or if you have a valid case for appeal.

Formally Challenge the Denial

If you believe the denial is unjustified based on your policy and the circumstances of your claim, don't hesitate to challenge it. Insurance companies typically have an appeals process in place. This process often involves sending an adjuster to reevaluate the extent of the damage. By formally initiating this challenge, you're taking the first step toward shedding light on any possible misunderstandings or overlooked aspects of your claim. This reevaluation can be pivotal in securing the payout you deserve.

Appeal to Your State Insurance Department

If your formal challenge does not yield the desired results, you have the right to file a complaint against your insurance company through your state's department of insurance. Many state departments offer advocates who can provide invaluable assistance. They will guide you through the intricacies of the process and may even conduct an investigation into the denial on your behalf. State insurance departments are designed to ensure that insurance companies follow the law and treat policyholders fairly.

Engage a Public Adjuster

When navigating the complexities of a denied claim, expert guidance can make all the difference. This is where a public adjuster comes in. Public adjusters are professionals who work exclusively on behalf of policyholders, not insurance companies. Their primary role is to prepare, present, and negotiate insurance claims to ensure policyholders receive fair compensation for their losses.

Public adjusters bring a wealth of experience to the table. They often handle claims every day, giving them unparalleled expertise in dealing with insurance companies. They can assist in negotiations, advocating on your behalf, and assessing the ideal path to pursue based on the circumstances of your claim. Public adjusters are particularly valuable when denied claims involve significant damage and complex policy issues.

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About the Author

Stuart Dorf, JD, CPAU | Executive Vice President

Stuart Dorf, JD, CPAU, Executive Vice President at Globe Midwest Adjusters International, is a licensed public adjuster, appraiser, umpire, and attorney who specializes in securing fair insurance claim settlements for property and business owners. With over 20 years of experience in commercial real estate, law, and marketing, he holds licenses in multiple states, actively participates in legal associations, and has a strong entrepreneurial background. He earned his law degree from the Illinois Institute of Technology’s Chicago-Kent College of Law and graduated with honors from Tulane University.

sdorf@globemwai.com | 248.915.0399