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Insurance Claim Denials – How to Fight Back and Win
- Sep 19, 2024
- Sohel
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Few things are more frustrating than paying your insurance premiums for years only to have your claim denied when disaster strikes. Unfortunately, insurance claim denials are common, especially with property damage claims. The good news is that a denial is not the end of the road. With the right knowledge and strategy, you can challenge the decision and fight for the coverage you deserve.
Why Insurance Claims Get Denied
Insurers may deny claims for a variety of reasons, including:
- Late filing – missing the strict reporting deadline.
- Insufficient documentation – lack of photos, receipts, or repair estimates.
- Policy exclusions – damage that falls under fine-print loopholes.
- Pre-existing conditions – claiming for issues the insurer argues existed before the event.
- Disputed cause of damage – insurer claims it was wear and tear, not storm, fire, or water damage.
Steps to Take After a Claim Denial
Step 1: Read the Denial Letter Carefully
Your insurer is required to explain why the claim was denied. Review the stated reasons against your policy langua
Step 2: Gather Additional Evidence
- Get an independent contractor’s estimate
- Collect witness statements if available
- Take before-and-after photos to show the damage is event-related
Step 3: File an Appeal
Most insurance companies allow policyholders to formally appeal a denial. This requires additional documentation and sometimes a legal response.
Step 4: Consider Professional Help
- Public Adjuster: Represents you and re-estimates damages.
- Claim Support Specialists (like iClaimVia): Navigate the appeal process.
- Attorney: In severe cases, legal action may be required.
Common Misconceptions About Denials
- “A denial means I can’t recover anything.” – False. Many denials are overturned on appeal.
- “The insurance company’s decision is final.” – False. You have rights under state laws.
- “It’s too expensive to fight back.” – False. Claim support services often save far more than they cost.
Preventing Denials Before They Happen
- Report claims quickly
- Keep detailed property maintenance records
- Review and update your policy annually
- Get professional support when filing large claims
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FAQs
Yes, if they act in bad faith, but most cases are resolved during the appeal process.
Each insurer has its own timeline, but most allow 30–60 days after denial.
Yes. Policyholders with representation recover significantly higher settlements.
Possibly. Some insurers raise rates after claims, especially if you’ve filed multiple in a short time.
You can request a reassessment, provide additional documentation, or file an appeal.
Yes. Keep damaged items until the adjuster inspects them, unless they pose safety risks.
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