When you suffer property damage, you don’t want to mess around with an insurance company that wrongfully gives property damage claim denials for damages. When you pay the premiums, you expect to receive payment when you submit a valid claim. If an insurance company denies a property damage claim, you have rights. Palumbo Law knows how insurance companies play the game and will fight for your right to repayment in Rhode Island, Connecticut, and Massachusetts.
Property Damage Claim Denials
There are several excuses an insurance company may use to deny a claim for property damage if the company simply doesn’t want to payout. Commonly given reasons include:
- Non-payment of premiums
- Exclusion clauses
- Failing to file a claim on time
- False or questionable claims
- Insufficient evidence of damages
- Failure to take adequate preventative measures to avoid damage
In addition to these, there are many reasons an insurance company may deny a claim. The basic premise is the insurance company believes it is not required to pay the claim under the insurance policy, the contract defining the relationship between you and the company.
Some of these reasons are based on your failure to live up to your end of the contract. These include failure to pay premiums or failure to take preventative measures to avoid damage.
Other reasons are based on the language of the insurance policy. If you read an insurance policy closely, you will see the terms include many exclusions or situations the insurance company is not responsible for covering. To avoid paying claims, insurance companies try hard to make sure your claim fits into one of the itemized exclusions.
How to Prevent Claim Denial
- The first step to prevent claim denial is to make sure you have adequate insurance coverage. One example of carrying adequate insurance coverage is carrying flood coverage if you live in or near a flood zone. If you do not have flood insurance, your insurance company will likely deny any claims for flood damage.
- Another prerequisite for claim approval is the payment of all premiums. The premium is the agreed amount the insurance policyholder pays to the insurance company for a set amount of insurance coverage. If you miss a premium, the insurance company must give notice of the missed premium and an opportunity to cure the payment before canceling coverage. However, if you have not kept up with all required insurance premiums, an insurance company will likely deny any claims under the policy.
- File all claims on time. The deadlines for filing claims are usually set out in the insurance policy. In some instances, such as a natural disaster, the deadline to file a claim may be extended based on the circumstances, but generally, you must file all claims by the claims deadline to receive payment.
- Take photos of damages and save copies of repair estimates and invoices for restoration. Submit these documents as proof of your claim to support the type of damage and costs of repair.
- Read your policy carefully for exclusions. If you believe an exclusion leaves you unprotected, contact your insurance company to discuss obtaining coverage for a particular risk.
If Insurance Denies Your Claim
If an insurance company denies a claim for property damage coverage, the company is required to send you an explanation of the denial. The explanation of denial typically includes a deadline for you to file an appeal or review of the denial. To preserve your rights, do not let this deadline pass without submitting the required request for appeal or review.
If the insurance company denied your claim based on lack of evidence, submitting additional evidence of damages and costs of repair may resolve the denial. If the insurance company refuses to approve your claim upon review and you believe you are entitled to payment, you may file a complaint with your state’s insurance bureau or other body in charge of regulating insurance companies.
If you are still denied payment, you may file a complaint or a lawsuit asserting your rights under the insurance policy. This type of lawsuit is essentially a breach of contract claim, alleging the insurance company did not live up to its requirements under the policy.
Obtaining Legal Help for Property Damage Claim Denials
An attorney experienced in dealing with insurance companies and with knowledge of the law can assist you in making sure your receive payment for your claims. If an insurance company is jerking you around from the start, it may be to your advantage to consult with an attorney before submitting a claim. Otherwise, you might consult an attorney upon receipt of the explanation of denial letter to ensure you preserve your rights to appeal.
An attorney may be able to negotiate with the insurance company to secure payment under the policy. If all else fails, an attorney can file a lawsuit against the insurance company claiming your right to payment. In addition to recovering payment under the policy, an attorney may also obtain damages for bad faith denial of claims under state law. This is a special remedy available when an insurance company improperly denies a claim for no good reason.
Consult with Our Rhode Island, Connecticut, and Massachusetts Property Damage Claim Denials Attorney
If you believe your insurance company wrongfully denied your claim for payment under an insurance policy, you should consult with an attorney experienced in handling claim denials. At Palumbo Law, our attorneys know all the tricks insurance companies try to pull to avoid paying out claims. Contact our Rhode Island, Connecticut, or Massachusetts offices today to discuss your rights to payment.