There are many reasons why you may have to deal with a denied homeowners insurance claim in Florida. Find out why your homeowners insurance claim may have been denied and what you can do about it.

A homeowners insurance policy is a type of property insurance that protects a person's home and personal belongings from loss and damage. It combines several types of coverage such as exterior damage, loss or damage to personal goods, and injury that occurs while on the property. Usually, the insurance department provides a number you can contact as a homeowners insurance policyholder to start the claims process.

The worst news is finding out your insurance claim has been denied after major losses to your house such as fire, flood, storm, vandalism, or burglary. Typically a property insurance claim can be refused – sometimes for good reason, sometimes in error, and occasionally for no obvious reason.

There are measures you can take to question your homeowners insurance claim denial if you've experienced an insured property loss and your insurance provider has refused your claim. A homeowners insurance lawyer can help with the process.

Common Reasons for a Homeowners Insurance Claim Denial

There are many reasons the insurance commissioner can deny one's insurance claim. Here are some reasons a homeowners insurance claim can be rejected:

  • Lack of Coverage for the Type of Damage

Although home insurance can protect you against a variety of threats, it does not cover every form of loss. A standard home insurance policy normally covers damages caused by fire, lightning, and wind, but the policy has several limitations.

Natural disasters like damage from earthquakes and flood damage, mold damage, and water damage are not covered unless you pay an additional price to include them in your property insurance policy. If the cause of the property damage is not listed among the covered events in your insurance policy, you might be denied your insurance benefits.

  • Failure to Pay Premiums

It is pretty risky to skip payments on your house insurance or pay your premiums late. If your insurance lapses and your home suffers damage, the claims adjuster can recommend a claim denial. Having a history of missed or late payments can also harm your credit rating, resulting in higher premiums in the future.

  • Waiting Too Long Before Filing

Home insurance claims must be filed and documented within a certain period of time. If you miss the filing window for the claims process, which is usually a 30-day period to a year depending on your policy, your claim will be denied, regardless of how valid it is.

  • Insufficient Evidence

When making a home insurance claim, lying about the nature and degree of the damage is possibly the worst error you can make. The insurance company will send their insurance adjuster to your home after a disaster to inspect the damage and estimate the replacement cost.

If they discover that you were not completely honest or provided false information on your claims form, your claim is likely to be denied. Never give false information or try to conceal previous claims to your insurance provider to keep your no-claims discount.

File a formal complaint with the detailed nature of the damage and additional evidence. You can also get a public insurance adjuster to help you document your losses.

  • The Loss Isn’t Greater Than the Deductible

Every homeowners policy in Florida has a deductible that you must pay before your insurance coverage takes effect. As a result, if the damage is less than the deductible, you will have to pay for it yourself. Therefore if your policy's deductible is $5,000 and the repair cost is less than that, the insurer will deny your claim.

  • Wear & Tear

Homes are built to last a long period, yet over some time, they can wear down. Almost all homeowners insurance policies require that the property be well-kept and in good repair. If the insurance board determines that the damage was caused by normal wear and tear or that the incident that initiated the claim was caused by your negligence, your claim is likely to be denied. Your home should also have fire alarms and security systems, and your insurer will need the payment receipts to confirm the installation.

What To Do When Your Homeowners Insurance Claim Is Denied 

Homeowners insurance claims are routinely denied or undervalued by insurance companies. You will definitely anticipate your insurer to meet its agreements if you have been making your insurance payments consistently and on time for many years.

A claim denial can be made for good reason, bad reason, a mistake, or for no reason at all. An insurer who has refused your valid claim has made a bad faith insurance denial. Here are the measures to take after receiving a letter of denial:

Understand Why Your Claim Was Denied

Your insurance agent should send you a detailed denial letter as well as the portion of the policy that supports the decision. Follow up with the adjuster if you haven't received proper notification. If your insurance company did not send you a formal letter, your insurance claim has not been denied.

The insurance company is required to explain the denial. Compare their explanation to your policy statement. There is little you can do if your claim is denied for a valid reason, such as the premium not being paid or the sort of damage being explicitly excluded from your coverage. Request clarification from the adjuster if the denial is unclear.

File an Appeal

You may need to file an appeal if you are not getting any satisfaction from explaining your position to your insurer. You only have a certain amount of time to do this once your claim is denied. Follow the appeals process outlined in your homeowners insurance policy. 

When you file a formal appeal, your refused claim is reviewed. Include sufficient evidence and documentation to prove that your damages should be compensated. The more systematic you are when presenting this document, the more likely you are to get a thorough reconsideration of your refused claim.

Consult Property Insurance Claims Professional

A public adjuster can confirm your type of coverage, document and value your damages, and negotiate the maximum payout allowed by your homeowners insurance policy. The sooner you contact a public adjuster, the more he or she can do to assist you in regaining your financial footing.

If you've already reached the point where you need to sue your insurance carrier, find a qualified attorney who specializes in property insurance claims. Obtain references that demonstrate a successful track record in resolving property insurance claims, rather than just a knowledge of property law.

If you filed a claim for coverage after a loss, you could face payment delays, unjust or partial payouts, or even having your claim denied outright. Insurance companies have a responsibility to uphold policies, but they may behave in bad faith once a claim has been submitted.

If your insurance claim has been delayed or refused, an insurance claim dispute lawyer can look into it and help you get the money you are owed. Consult an insurance attorney for legal action at VG Law Group, LLP today. We offer free initial consultations.

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