Disputing a Denied Claim

Discrepancies are common between insurance companies and policyholders. Consumers pay premiums to make sure insurance companies fulfill claims. However, insurance companies want to pay as little as possible. The less they pay, then the more they profit. This doesn’t mean every company automatically tries to hurt policyholders, however there should be fair compensation. 

Receiving a Denied Claim

Normally, a denial starts with a formal letter from your adjuster.  The letter should have specifics of the denial along with an explanation of their reason for denying the claim. Call your insurance company if you never received a letter. Compare their reasons with your policy. 

Denial Terms

Sometimes an insurance company will use unclear terminology. Here are some common terms and helpful explanations that deal with denied claims.

Covered Perils

When there is a sudden loss of a claim, this can be called an occurrence. The immediate source of damage is called a perilPerils are a specific risk or cause of loss covered by an insurance policy. Examples of perils are fire, wind, lightning, or theft. However, different policies will cover different perils. For an insurance company to cover a claim, an adjuster must be able to see there was an occurrence caused by a peril covered by the type of policy you have.

Deductible Claim

An insurance deductible is the amount of money you as the homeowner agree to pay in a claim.  When the damage is less than your deductible than your insurance policy would not have coverage for that claim. The most common homeowner’s deductible is $1000. However, hurricane deductibles work differently. Insurance companies charge high out of pocket deductibles for hurricane losses. these can be 2% – 5% of the policy coverage amount.

Exclusions

Certain things are limited or specifically excluded in homeowner’s policies. The most common exclusions are floods and water back-up/sewage overflow. These are common in coastal states, like Florida. Perils can be covered separately for additional cost, but people tend to be blind-sided after storms to find out their policy excludes hurricane/wind and hail.

Take Action

Don’t let ambiguous terms in the denial stop you from asking questions to your insurance company. Make sure to document everything. This includes names, dates and times. You will need to fill out an appeal form with your insurer, but lay out your rebuttal. Ask for an impartial viewpoint like us at The Michael Brady Lynch Firm. Most of all, ask the insurance company for a resolution date. Do not expect the process to move quickly. We will keep following up if the deadline passes.

Get Help with Your Claim Denial

Insurance claim disputes are common. They occur for a number of reasons. Sometimes the insurance provider simply wants to try to resolve a claim in the least expensive way possible. They may not provide accurate evaluations of your damages or losses. Other times, they might make it difficult for you if you fail to provide proof of your losses. You can provide proof of losses by hiring your own adjuster to examine your premises and make a report. Florida hurricane insurance dispute lawyers help you obtain the proof you need to get the most from your claim.

A denied hurricane insurance claim can be frustrating and keep you from being able to make repairs to your home or business. You need guidance from a knowledgeable attorney. You need to get the most from a claim, so you are able to fix your home and move forward after the devastating hurricane.

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