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Clients often ask us why property insurance claims are denied. There is no one answer—there are many reasons a claim may be denied. If that happens, the insurance company is required to provide the reason for the denial based upon the terms and conditions of the insurance policy. An insurance company cannot deny a claim without relying on specific terms and conditions of the insurance policy as the basis for its claim denial.
The Top 10 Reasons For Denied Claims
1. The insured did not give timely notice of a claim
2. Damages are not covered under the insurance policy
3. The insured did not protect the property from further damages
4. A Proof of Loss form was not provided timely
5. The insured failed to provide the information or documentation requested
6. The damages do not exceed the policy deductible
7. The insured did not give an “examination under oath” or “recorded statement”
8. No inventory of damaged personal property was provided
9.The cause of damage is not covered under the insurance policy
10. The insured did not cooperate in the investigation of the claim
What Should I Do If My Claim Is Denied?
A claim can be denied for many different reasons. If your claim is denied, you should consult with an attorney as soon as possible to protect your rights. Both Florida law and certain policy provisions may prevent insureds from having any legal recourse against their insurance companies if they do not challenge a denied claim in a timely manner.
Just as insurance companies have attorneys and adjusters working on their behalf and in their interest, insureds should have attorneys or public insurance adjusters to help them navigate the claim process. Your attorney or public adjuster can help ensure that you have fully complied with the insurance company’s requests and requirements and can make sure the insurance company is treating you fairly and your interests are protected.
What Steps Can I Take to Prevent a Denial?
When a loss occurs, you are required to put your insurance company on notice of the damages immediately. You can file your insurance claim directly with the insurance company or with your agent. You may also retain an attorney or a public adjuster to report a claim on your behalf. You can report a claim on the phone, online, or by speaking with your agent. Regardless of how the claim is reported, make sure you keep a record of how and when you filed the claim, who you talked to, and the assigned claim number. Always keep a copy of any claim correspondence to or from the insurance company for your records.
Based upon new changes to Florida Statues in 2021, insurance claims must now be reported to insurance companies sooner than previously required under the law. Florida Statute § 627.70132 requires an insured to provide notice of a claim or a “reopened claim” within two (2) years of the date of loss. The insured must provide notice of a “supplemental claim” within three (3) years of the date of loss. A “reopened claim” is a claim that was previously closed but reopened for additional costs for loss or damage previously disclosed. A “supplemental claim” is a claim for additional loss or damage from the same peril previously adjusted or for costs incurred while completing repairs.
Insurance claims can be extremely complex. Most insurance policies are now over fifty pages long. A claims professional can help you navigate the claims process and can help ensure that your claim is not denied, or underpaid.
Murray + Murray Can Simplify the Process
If your insurance company has denied, delayed or underpaid your claim, or if you believe that you are being treated unfairly or in bad faith, contact an attorney at Murray + Murray for a free consultation. We exclusively handle insurance claims, and will always hold insurance companies accountable.