What to do if your property insurance company refuses to pay your claim

Contrary to what most people believe, insurance companies aren’t in the business of making sure customers receive generous payouts

It can be a shock to hear “denied” from a property insurance company. After all, there is a reason we pay (often hefty) premiums month after month, year after year. There is comfort in knowing that if a tragic or unsettling event were to happen, such as a tree falling on our house, a destructive storm damaging an apartment building, or a thief slipping away with a roomful of high-end computers, we would be made whole.

When your insurance company refuses to pay a claim, it can be maddening, upsetting, and confusing. What are you paying premiums for, anyway?

The honest (financial) truth about insurance companies

Generally speaking, many people assume the insurance company is a genial friend, making sure we are covered generously when things go awry. That’s why learning your claim has been denied feels wrong.  But it happens. Or your claim may be accepted but underpaid.

How can a property insurance company deny a valid claim?

Insurance companies can and will deny claims that you believe are valid. Or they will start with a very low settlement offer in the hope that you accept it and move on. Here is a list of seven reasons why insurance companies refuse to pay valid claims:

1. Clerical mistakes or incomplete information: This is the simplest problem to clear up. Insurers may reject a claim that contains incorrect or missing information. They may also toss claims that lack photos, estimates, invoices, and other documentation.
2. No coverage: In this case, the insurer states that the claim is not covered by the policy (either specifically or due to a technicality).
3. Failure to notify: Claims have to be reported to the insurance company within certain time parameters.
4. Coverage has expired or lapsed: If you’ve ever forgotten to pay your premiums, you know it’s an easy mistake to make. Insurance companies will not pay when policies are expired at the time of the incident. (Consider this a friendly reminder to log in to your insurance portal and set up recurring payments!)
5. Insurance fraud: The insurance company alleges that you submitted a false claim deliberately.
6. Failure to mitigate: You did not exercise reasonable efforts to minimize or lessen an injury or damage.
7. Bad faith denial: Some companies just don’t want to pay their policyholders. You may get the runaround and roadblocks in your quest to get a payout on the claim.

Best practices for when an insurance company will not pay on a claim.

Grenier Public Adjusters is here to help you navigate the confusing work of making a property insurance claim with your insurance carrier. And, if you are denied, we help you jump through all the administrative hoops, if needed.

Here are some best practices that can help if your insurance won’t pay on your claim.

Know everything about your policy

As public insurance adjusters, we’re experts at reviewing property insurance policies. But if you are going solo, go over every line in the policy and write a list of questions you want to ask. Insurance companies aren’t perfect, just like any organization. Mistakes may have been made in the interpretation of one or more clauses.

Be persistent

Get ready to contest the denial; most people do not. You will need a notebook or spreadsheet to keep track of every call, email, and snail mail letter.

Get it in writing

Call your agent (if you have one) and try to maintain written communication, such as email. If you’re really stuck, consider messaging the company on social media. Always reference your claim number and include contact information. Keep excellent notes.

Most states require insurance denials to be provided in writing. If you don’t receive this, ask for it.

Stay alert for bad faith

Be on the lookout for jargon, obtuse explanations, and policy limitation and exclusions that were not disclosed to you prior to purchasing the policy. If the company consistently stonewalls in your attempts to get more information, you may have to seek professional assistance with the process.

How Grenier Public Adjusters can help

As a trusted public adjuster in Massachusetts with decades of experience, we are available at all hours to offer expert guidance through the confusing experience of property insurance claims. We’re also happy to review your policies and provide our best recommendations. Please contact Grenier Public Adjusters or call 774-239-6822 anytime.