The Top 6 Reasons Insurance Claims Get Denied and How to Avoid Them

If your property gets damaged, you might think that getting your insurance claim will be an easy process. That’s especially if you’re sure that the other party was responsible for the damages. But you might be surprised to realize that your insurance claim has been denied.

If you, for instance, get your property damaged in a tornado in Florida, you’ll be faced with expensive repairs to the damaged property. You might also be faced with a temporary loss of income if you get hurt in a house fire where your property gets damaged. As such, recovering compensation from an insurance company should be straightforward. But this is not always the case.

That’s because most of insurance companies are not interested in helping you get the compensation that you deserve. So they’ll do everything they can to either limit your payout or ensure that you don’t get anything.

It’s important to understand the reasons why an insurance company may deny you insurance claims. That’s because the reasons can incredibly help you in fighting for the compensation that you deserve. 

Reasons Why Insurance Claims Get Denied and How to Avoid Them

Any Floridian that understands their rights, depends on their insurance when disaster strikes. It might be a burst copper pipe or even a burglary. Whatever it is, you know that your insurance company will keep its part of the deal and compensate you.

The fact, however, is that a lot of people end up contacting a Florida public adjuster because their insurer denied their claim. These people are usually shocked because they believed that they had done everything by the book. Your insurance premiums were up to date, you informed your insurer about the covered event, and filed the claim form.

But when a Florida public adjuster does an inspection, they realize that there are problems that may have caused the denial. What are these problems and how do you avoid them? Let’s find out below.

  1. Illegal Exclusions

Remember that insurance companies don’t always play by the rules, especially if they know that they can get away with it. Their public adjuster can cite exclusions from coverage to deny your claim or reduce the amount that they need to compensate you with.

Any reputable adjuster licensed by the Florida department of financial services should tell you if the exclusion isn’t legal. They must also be able to tell you whether the damage can be included in the scope of loss.

Thus, you shouldn’t give up in case your claim gets denied by reason of exclusion. In fact, you should contact a Florida public adjuster as soon as you notice any sign that your claim can be denied. 

  1. You Were Partially or Fully Responsible for the Damages

It’s crucial to understand the terms and conditions of your policy contract with the insurance company. That’s because the company will not pay your claim if you were involved in behavior that can void your coverage.

Drunk driving, for instance, almost always voids insurance claims. Your insurance claim can also be denied if the accident occurred when an unlicensed driver was using your car without your permission and it got damaged. The company won’t pay either if you were responsible for something that was in the terms of your insurance policy.

The other reason for the denial of a claim settlement would be if you were breaking the law at the time of the incident that got your car damaged.

You must note that the denial of insurance claims is not only about intentional wrongs. The insurance company can also refuse to compensate you if there are ways in which you could have avoided the damage to your property. 

  1. Lack of Evidence to Establish Fault

An insurance claim can be denied if there’s a dispute as to who is at fault.

An insurer will only agree to pay you if it’s clear that their policyholder is to blame for damages. If there’s any indication that their policy holder is not to blame, the insurance company will deny your claim.

A claim can also be denied if there’s proof that their policy holder isn’t entirely liable. In Florida, anybody that contributes to an accident is usually held responsible for the damages. Thus, insurance companies are usually careful in investigating to determine if you or anybody else had a role to play in the unfortunate loss of property.

If there’s proof that more than one person was at fault, the insurance company will most likely deny the claim for their benefit. 

  1. Failure to Have an Attorney

It’s always advised that you hire an attorney if you intend to file a lawsuit to claim insurance compensation. That’s because an insurance company can easily take advantage of you if you don’t have legal representation.

They’ll assume that you’re not entirely familiar with your legal rights, a factor that can be used against you. They can decide to unnecessarily delay the processing of your claim. They can also choose to make it difficult for you to speak with a representative.

These strategies are designed to make you buckle under financial pressure. That way, you’ll be willing to accept any lowball offer that they may extend. But you can protect yourself by getting legal representation. An experienced attorney will ensure that your claim is handled with the intention it deserves for you to get compensation. 

  1. Missing Documents

An insurer will always ask for various documents when you file an insurance claim. Such documents may include proof of ownership for damaged items and the documents stating their current value. In some cases, you may not have these documents. Sometimes you may even miss the deadline for sending them.

But whatever their reasons are for denying you the claim, it’s important to get in touch with a Florida public adjuster. That’s because they can overturn denied claims and win the compensation that you need. 

Conclusion

There are a lot of factors that drive insurance companies to deny claims. Regardless of who is at fault, it’s a fact that denials can occur. These denials can be attributed to how complex insurance lawsuits can get.

That’s why it’s important that you work with an attorney and a public adjuster. This will ensure that everything is documented and that you follow all the rules in the book to increase the chances of getting compensated.

Meta Description

In this article, we talk about how insurance claims get denied after an accident or damage to your property. Find out about the factors that insurers take advantage of to deny you your claims and how to avoid them. We talk about missing documents, illegal exclusions and a lot more.