If Your Insurance Claim Gets Denied Find Out Why

So, you live in Northeastern Indiana, you renew your home owner’s insurance every year and hope you’d never have to use it. However, accidents happen – your Fort Wayne home suffered a water damage, you filed a claim with your insurance company and they denied it even though you did everything by the book.

You filed a claim as soon as possible, provided them with complete and correct information and even included pictures of the areas that sustained damage. And regardless of all that it looks like you’ll be the one to foot the repair bill.

Don’t despair yet, though. There are things that can be done before you call it quits. The information below will help you better understand why the water damage claim was denied and what you can do to increase the chances of it being approved by the insurance company.

1. Find out why your claim was denied – As soon as you get a letter notifying you that your claim has been denied, call the insurance company and ask for a full explanation. Every policy has exclusions and it is important for you to understand exactly what part of your policy excludes the damage that you are looking to have covered.

   One thing to keep in mind is that during the claim you’ll be working with a few different people, so it’s very important to find out where the decision is coming from. Was it the adjuster? The agent or a contractor? Each of these people has a different role in the process of approving or denying your claim, so don’t be afraid to ask for clarification in order to avoid misunderstandings.

   Before you even pick up the phone to call your insurance company, know that whether you’ll get paid for the damage depends on whether the event was sudden (accidental) or not. If it wasn’t (a pipe that’s been leaking for weeks) your claim most likely will be denied.

2. Ask for second opinion – It’s possible that even after you get an explanation from the insurance company about why your claim was denied, you still won’t understand why something isn’t covered. In this case ask for second opinion.For starters – talk with your insurance agent, it’s in his best interest to fully explain your coverage and see if there’s anything that can be done to make the insurer reconsider.

   A few other people you should consider talking to are the claim adjuster or supervisor/ombudsman at the insurance company.However, if you are not satisfied with the answers you got from these officials, you can turn to the Indiana State Insurance Commissioner.Their job is to make sure you are being respected and things are being done fairly.

   However, be advised that the process of reviewing your case is time consuming so you’ll have to pay out of pocket for repairs resulting from the water damage.

3. Hire an attorney – When you file a complaint with the State Insurance Commissioner, they will get in touch with you and ask you to provide them with additional documents they might need before they send a copy of the complaint to the insurance company.The insurance company is usually given a designated amount of time to respond and if the response is adequate, the office of the commissioner with send you a copy of their letter.

   If they think the answer from the insurance company is not adequate, a person designated by the state will take over your case.Even though it sounds like this designated person acts like your attorney that’s not the case.If you think that they won’t be able to help you in your dispute with the insurance company, you should consider hiring an attorney to represent you and handle your insurance claim. Usually the initial consultation is free, so you have nothing to lose and if you decide to hire a lawyer, their fee is paid by the insurance company.

When your home suffers water damage and your insurance company denies your claim, know that there are other avenues you can explore to get compensation for the damage your home sustained.