Here’s Why Your Fire Insurance Claim May Have Been Denied And What To Do After
Even the most cautious and responsible homeowner may experience a fire that damages or destroys their property. Fire loss is a common issue for homeowners in Florida. In fact, according to the Insurance Information Institute, a home fire was reported every 89 seconds in the United States in 2020.
In these trying times, you turn to your homeowner’s insurance policy and file claims to help ease the burden of replacing everything you own and repairing your house and help you and your family get back to normalcy.
You expect your insurance will come through and support you and your family, especially since you’ve faithfully paid your premiums for years.
However, insurers will work overtime to underpay or deny a claim. If you’re struggling to get what you deserve from your homeowner’s insurance company, you need to know your rights and how to fight back.
Let’s look at five reasons insurance companies commonly deny fire claims in Florida and what you can do in the future to prevent denied house fire claims.
Five Reasons Insurance Companies Deny Florida Fire Claims
In 2020, about 42.3 million, or 18%, of homeowner insurance claims in America were denied. If you experienced an underpaid claim or a claim denial, you might be frustrated, but you’re not necessarily out of luck.
The first step is to arm yourself with information that will help you understand why the insurance company denied or underpaid your claim.
Let’s look at five common reasons your insurance company may have denied your fire insurance claim.
1. The Insurance Company Says Your Policy Doesn’t Cover Fire Claims
If your insurance company sites “insufficient coverage” as the reason they denied your claims, it could mean the specific fire type isn’t covered by your homeowner’s insurance policy.
It could also mean that your policy is limited to damage caused by flames and not smoke damage. You may also not be covered for water damage that results from the fire.
Your insurance company is only required to pay for damages covered by your specific policy. However, sometimes insurers will wrongfully deny house fire property damage claims that you’re covered for. Be sure to read your property insurance policy, paying close attention to the house fire portion to ensure you are covered should you experience a home fire in the future.
If you suspect you’re entitled to full coverage, and you’ve been wrongly denied, you can contact a trusted Orlando public adjuster to help evaluate your policy and damages to identify exactly what you are entitled to.
2. The Claim Lacks The Right Documentation
As you try to rebuild your life after a home fire, it’s easy to overlook specific documents needed to file your claim with the insurance company. If you haven’t provided the proper evidence that proves your loss, including documentation demonstrating the value of your lost or damaged personal property, you may find your claim denied.
For example, if you claim that you lost a $2,000 laptop computer, your insurance company may require proof that you owned one. In this case, receipts, bank statements, online registration, or photos could be proof of ownership.
So if you can’t support the claimed value of the damaged items, your insurer will not cover their loss or will offer coverage at a reduced rate.
3. They Suspect Insurance Fraud Or Misrepresentation
Misrepresentation is another way of saying your insurance company doesn’t believe certain aspects of your claim. They may suspect fraud, where you are claiming something happened that didn’t, or that you’re misrepresenting the situation.
This means that your insurer suspects you may not have been sincere in your claim. For instance, if your teenager left a candle burning and knocked it over, you may say it fell over on its own because you’re afraid your claim will be denied if you’re upfront about the incident.
Always be 100% honest with your insurer. Insurance companies can visit the fire site and investigate the incident. They have access to any reports from the fire department and will cross reference them with the property owner’s claim. So it’s in your best interest to always tell the truth and be upfront with your insurer.
4. Illegal Activity, Arson, Or Possible Foul Play Was The Cause Of The Fire
Suspected fraud, arson, or illegal activity are the most common reasons for claim denial. This can be highly frustrating for homeowners just trying to get back on their feet.
Several scenarios could prompt this response. You may see language in your claims report that indicates this view, such as:
- The insurer believes that you or another party committed arson to defraud the insurance company.
- According to the report, the fire department could not identify the fire’s source.
- There is reason to believe you are not being honest about the details in the insurance claim.
If this is the case, you must consult with an insurance lawyer and meet with an Orlando public adjuster to review your claim and determine your course of action.
5. The Insurance Company Finds Unpermitted Electrical Work Or Prior Damage
As a homeowner, you’re responsible for maintaining your property. That means completing regular home maintenance and hiring reputable companies to work on your property, especially when it comes to electrical work.
You must work exclusively with bonded, licensed, and insured electricians to ensure that you are covered should an incident arise that leads to a fire on your property. Not only are they highly qualified to get the job done, but they are certified, which means specific governing bodies have vetted their work.
If you hired an unlicensed electrician and their work led to a house fire, it could reduce or negate your insurance claim.
Additionally, if your insurance adjuster finds evidence of existing wear and tear caused by natural weathering, they could reduce your claim. This is because your insurance policy only covers damage done by the house fire and will not cover existing maintenance issues.
Source: Unsplash
Preventative Measures Can You Take To Avoid A Denied Claim
If your insurance company has denied your fire damage claim, you should request a written justification letter and review your policy with a public adjuster to see your next steps. This is the best way to navigate your appeal and get back on your feet.
While the hope is you never have to file a fire damage claim again, there’s always the possibility you may need to. If so, there are several things you and your family can do ahead of time to ensure your future claims have a better chance of being approved in full.
Here are some preventative measures you can take to protect yourself and increase your chances of receiving full home insurance benefits.
Always Pay Your Insurance Premiums
You must pay your premiums in full and on time as a policyholder. If you miss them, you may be in a tough predicament following a house fire.
Consider setting up auto-payments or using a calendar to ensure your premiums are paid on time. This will help prevent a denied claim in your time of need.
Develop A Safety Plan
In 2020, nearly 24% of all homeowners insurance losses were caused by fire. Since you have to prove that you did everything in your power to mitigate the property damage, develop a solid safety preparedness plan with your family.
Make it a habit to regularly check the batteries on your smoke alarms and carbon monoxide detectors. Purchase fire extinguishers in rooms with a high risk of fire, like the kitchen.
This shows the insurance company that you’re not acting in “bad faith” and have taken reasonable steps to prevent and handle a house fire.
Keep Meticulous Records
Invest in a lockbox that’s both fireproof and waterproof. Store important documents and receipts for valuable items like jewelry, electronics, and appliances.
This will ensure you can prove the value of your belongings and prevent your claim from being denied for lack of documentation.
Be Up Front And Honest With Your Insurers
In the event of property loss or damage, you must describe the incident to the best of your ability. Always be accurate with your experience and how the house fire started.
An Orlando claims adjuster will visit the property to survey the damage and compare those observations with notes from the fire department and police report. Being upfront and honest will ensure you receive a more accurate insurance settlement.
Let A Public Adjuster Fight For Your Fire Damage Insurance Claim
Seeing a denied insurance claim is stressful when dealing with a total loss or even minor property damage. It’s essential to get to the bottom of why you’ve been denied and figure out how you can move forward.
The best course of action is to contact a public adjuster. If you feel that your insurance claim has been wrongfully denied, contact NeJame Claims Adjusting.
We can help you look into your claim and identify whether or not you have a solid case to get you the settlement you deserve.
Resources:
Claims Denials And Appeals. (2022). In KFF. Retrieved from https://www.kff.org/private-insurance/issue-brief/claims-denials-and-appeals-in-aca-marketplace-plans/
Facts + Statistics: Fire . (2022). In Insurance Information Institute . Retrieved from https://www.iii.org/fact-statistic/facts-statistics-fire
Facts + Statistics: Homeowner’s and renter’s insurance. (2022). In Insurance Information Institute . Retrieved from https://www.iii.org/fact-statistic/facts-statistics-homeowners-and-renters-insurance
FAQs
What is the difference between a claims adjuster and a public adjuster?
A claims adjuster investigates an insurance claim to determine how liable an insurance company is. A public adjuster is a licensed insurance professional that reviews claims and advocates for the insured’s best interests.
How long do I have to file a fire damage insurance claim?
Homeowners have up to one year to file a claim, but the sooner you file, the sooner you will have the help you need.
How long does it take to settle a fire claim?
It can take about 90-120 days to receive insurance money after filing a house fire claim.
Recent Comments