Underpaid or denied claims

 

People might not realize what to do when they have underpaid or denied claims. When you have a catastrophic event happen that damaged your home you might first turn to your insurance company for help. That is why you have insurance. To help you rebuild your property and get back to normal. Many people will file an insurance claim and see what happens. They trust that their insurance company has their best interest at heart. Many of them do have the insured’s best interest at heart. Even if the insurance company has your best interest at heart that does not mean things are going to work out in your favor. You still may be underpaid for your claim or denied altogether.

After filing your claim an insurance company will typically send out a representative. This representative is usually an insurance adjuster. Sometimes the insurance company will send out an engineer to inspect the claim. This representative will assess the damage and send a report to the insurance company so they can decide on how to pay the claim or if they should deny it. The insurance company is required to do one of those two things.

Paid claims

When I say paid claims, I am referring to a claim that was adequately paid by the insurance company. The insurance company made you an offer to repair the damages to your property that you felt was enough to complete all repairs. This is an ideal situation. However, from our experience, this happens very seldomly. Much of the time a claim will either result in an underpayment or a denial.

 

Underpaid claims

This brings us to probably the most common outcome of an insurance claim, where the claim is underpaid. This scenario happens when the insurance company agrees that there are damages to your property that are covered by your policy, however they only offer to pay you a fraction of what you believe it will cost to repair the damages.

Sadly, most people in this situation will just accept what the insurance company offers them. They will not try to dispute the payment, even though there are multiple options to help secure a larger settlement. This is where hiring a claims professional, such as a public adjuster, is extremely helpful. A claims professional can help build an estimate of damages that is more in line with industry standards. They can also evaluate your insurance policy and identify additional coverages that may also help recover damages. If the dispute for the payment amount continues a claims professional can help navigate what might be the best options for resolving that dispute such as appraisal or mediation, to name a couple.

 

Denied claims

Denied claims can be a tricky thing to overcome. Insurance companies deny claims typically based on conditions in the insurance policy. Many policyholders that receive a denial from their insurance company will just accept it and not realize that they can try to fight that situation. If you have received a denial for a claim, it is extremely important to hire a claims professional to help assess the situation and discuss what options you may have.

 

When an insurance company denies a claim, they often cite that the loss was not something covered by your policy. From our experience, this often is incorrectly assessed. For example, a roof claim may be denied by the insurance company based on “wear and tear” not wind or hail, when there is clear creasing of shingles or even torn or missing shingles. A claims professional will come in to make their own assessment of the damages and provide this evidence to the insurance company as to why they have incorrectly denied the claim. A claims professional can also help navigate the situation and take the best path to helping turn that denied claim into a paid claim.

 

How we can help!

There are multiple outcomes to a claim if you are handling it yourself. There is only one outcome that we try to achieve, which is a fair and full settlement for your claim. Even if you feel that your claim has been adequately paid, it still may not have been. With our experience and the relationships that we have built, we are always up to date on current construction prices and can provide an assessment of your loss to make sure you have been paid fairly.

Our depth of experience and knowledge also lets us navigate and resolve the underpaid and denied situations. If either of these has happened to you it is important to not just let it go. You have options and resources at your disposal, all you have to do is send an email or make a phone call.