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When and how to fight a denied homeowners insurance claim

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Published on December 19, 2024 | 5 min read

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Images by Getty Images; Illustration by Issiah Davis/Bankrate

Key takeaways

  • Reviewing your home insurance policy before a claim occurs can help you understand what types of damage and events are covered by your policy and what is excluded.
  • When filing an appeal or disputing a claim, it is important to have the right documentation and evidence to support your case.
  • You may hire an independent appraiser or a public insurance adjuster to provide a professional opinion on your claim dispute.
  • If you feel your insurer has denied your claim unfairly, you may register a complaint with the state insurance department.

A denied home insurance claim isn’t always the end of the road. If you think your insurance company is giving you the short end of the stick, you can appeal or dispute the claim. But, before you start the process, you’ll want to carefully read your denial letter and coverage details to make sure you’re entitled to what you believe. Should you decide to move forward, here’s how to fight a denied homeowners insurance claim. 

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Why was my home insurance claim denied?

Your home insurance policy is designed to step in to cover financial losses you may not be able to afford entirely on your own, so it’s frustrating when that doesn’t pan out. But, your insurance company isn’t out to get you. There’s likely a legitimate reason why your insurance claim was denied. 

Some common reasons include: 

  • Lack of coverage: Home insurance policies cover a lot — but not everything. If you’re filing a claim for damage that’s not included in your policy, your insurance company will deny your claim. Flooding and earthquakes are two notable home insurance exclusions.
  • Missed filing deadline: There are time limits on when you are able to file a claim. Generally, this could be up to a year from when the incident occurred, but it can vary by insurer and state. Experts recommend filing a claim as soon as it is safe to do so after damage occurs.
  • Not enough documentation: If you fail to submit sufficient documentation, such as photos, videos or witness statements, it could result in a denial of your claim. Insurance adjusters rely on the details when making a decision, so the more supporting evidence, the more informed a decision the adjuster can make.
  • Negligence: You are responsible for the upkeep of your home, which includes regular maintenance and repairs. Failure to maintain your home or perform repairs as needed can cause your appeal to be denied if found to have contributed to the cause of loss.

What if my claim settlement is too low?

It’s possible that your insurance company approved your claim, but gives you a settlement that’s lower than what you need. In that case, you’ll want to carefully read your insurance policy and all other documentation related to your claim. Like a denial, you can also dispute an insurance claim settlement if you think your insurance company isn’t holding up its end of the deal.

How to dispute a denied homeowners insurance claim

There are several potential steps to take when preparing a case to dispute a homeowners claim denial. Much of this you can do on your own, but you may end up requiring help from a third party, whether that’s a public adjuster or lawyer. However, the first thing to do is review your homeowners policy to see what it says about the circumstances around the claim you filed. Specifically, you’ll want to see whether coverage is included and details indicate damage or loss is covered or if any listed exclusions would justify the denial.

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Watch out for personal property sublimits

Say you have $50,000 in coverage for your stuff, but your insurance settlement didn’t fully cover the cost of your stolen watch. That’s likely because your policy has certain sublimits for belongings that are more likely to be stolen like jewelry, cash, firearms and silverware. You might have $50,000 in personal property coverage, but your insurance company could cap jewelry theft coverage at $1,500. If you keep valuables in the home, consider adding a scheduled personal property endorsement to your policy to fully cover your items.

If you still feel the claim denial is incorrect, you’ll want to assemble and add to your documentation. What you need to document may vary depending on why your claim was denied. Photographs, receipts, police reports and even the written inspections of contractors can be useful evidence.

Once you’ve thoroughly reviewed your policy and documented your case, it’s time to speak with your insurance company to let them know you’re disputing the claim denial. If your appeal fails, it may be wise to employ a lawyer or similar legal counsel to assist moving forward.

Below, we outline in more detail how to fight a denied claim step by step.

Terms to know when disputing a home insurance claim denial or settlement

There are a few terms used in claims filing and processing that may be helpful to know up front.

Term Meaning
Appraisal An appraisal is a detailed assessment of either the property or property damage. An appraisal is written by an adjuster to estimate the amount of damage from a loss. The initial appraisal is usually provided at no charge from the insurance carrier.
Mediation Mediation is a meeting between a representative for the insurance carrier and the policyholder. A mediator will facilitate the meeting and both parties will present information regarding the claim. The goal is to find a solution for both parties.
Adjuster An adjuster is a professional hired to evaluate property damage. The adjuster will determine how much damage has occurred to the property. They will also recommend the amount to be paid out for the damage. Adjusters can be hired by the insurance company or by the policyholder.
Covered peril A covered peril is a loss or event that is covered under your home insurance policy. If your home or personal items are damaged by a covered peril, your home insurance policy should provide a payout based on the adjuster’s findings.
Coverage limit This is the maximum amount of money your insurance company will provide in the event of a covered loss. If the claim exceeds your policy’s coverage limits, you might have to pay the difference out-of-pocket.
Settlement A settlement is the payout you receive from your insurance company after a covered claim. It’s calculated based on the adjuster’s investigation of the claim, including what was damaged and the estimated cost of repairs. If you have a deductible, it will be taken out of your final settlement.

Frequently asked questions