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How one can dispute the rejection and settlement of home insurance claims – Bankrate.com

Dealing with damage or loss to your belongings can be stressful enough, but if your home insurance claim is denied after filing with your insurance carrier, it can add an additional burden. Fortunately, consumers have options for home insurance claims and no-settlements. If you find yourself in this situation, understanding the procedures that are available to you to challenge a rejection of a home insurance claim can help you resolve the matter. Bankrate outlines four steps that you can follow below.

1. Review your eligibility and coverage

As a first step, you should check your eligibility and coverage before contacting your insurer. This is important as you may not be able to remember all the important details of your policy, including the type of damage or event that is included in your coverage. When reviewing your policy, be sure to check what events and objects are in it, see if there are any exclusions, and review the claim filing process.

When reviewing the information originally submitted to the insurer, ask yourself whether the application was submitted correctly and with sufficient supporting evidence. If you still feel that the insurer has misjudged your claim, you need to properly understand the data you submitted in order to prepare for a follow-up consultation.

When you are sure that you understand the insurance policy, you can call the insurance company and request a re-examination of your claim or a re-examination based on new evidence. It is possible that an adjuster made a mistake the first time.

Tips for checking your insurance coverage

As you review your policy, it may be helpful to include the following steps in your initial review process.

  • Write down any questions you have as you read through the guideline.
  • Gather as much records as you can, including photos, testimonies, videos, and whatever other information you think is important.

2. Get another professional opinion

If you've requested a reconsideration of your claim and the request has been denied or resulted in the same denial, it may be time to seek additional professional opinion. As a consumer, you have the right to hire an independent appraiser or expert for public insurance. A public insurance expert is not affiliated with a specific agency and can be hired on your behalf to help you settle a claim.

When hiring a professional, look for references and recommendations. You should ensure that the appraiser is licensed in the state in which you are making the claim. You should also call your state insurance department to confirm the appraiser's records. While an independent or public assessor can provide useful assistance, there is an additional cost to hiring one. Independent appraisers can charge up to 15% of the settlement claim and there are no guarantees that the claim will be settled.

Hiring an independent party will either support the insurance carrier's initial rejection or support your claim. If the recommendation of the public insurance expert supports your claim, you can contact your insurance provider and ask to speak to the claims manager. At this point you can request a re-examination of the claim.

Tips on how to contact another insurance professional

When calling in an independent insurance expert, keep these tips in mind when hiring:

  • Ask friends or family members who have gone through the denial process and seek help from third parties for recommendations from public insurance experts.
  • Avoid hiring a public insurance appraiser to go door to door to do business after a disaster.

3. File a complaint with your state's insurance department

If you've hired a third party and the claim is still denied or offered too low, you can file a complaint with the state insurance company. This option may be best if you believe your insurer wrongly denied your claim and would like your state insurance department to investigate the situation to ensure that your insurance contract and state insurance laws have been properly followed. Calling the insurance office may also alert you to additional resources that you did not know were eligible.

4. Hire an attorney

Another option is to hire a lawyer, although this route has to be paid for out of pocket. Lawyers usually charge a consulting fee and an hourly rate for legal advice, which can add up the costs quickly. You need to weigh the cost of an attorney against the bottom line of approving a claim – or possibly rejection – and determining whether the process is worth it for you.

Tips for filing a complaint

When filing a complaint, keep the following in mind:

  • Ask the state insurance department if there are any resources available to contact the insurance carrier directly and discuss your claim.
  • The state insurance department usually sets a time limit for carriers to respond to a claim. You can inquire whether the insurer responded in a timely manner.

Conditions to be aware of if you contest the rejection or settlement of a home insurance claim

There are a few terms that are used in filing and processing claims that you may find helpful to know in advance.

expression meaning
Appreciation An appraisal is a detailed assessment of property or property damage. A surveyor prepares an appraisal to estimate the amount of damage caused by a loss. The initial assessment is usually carried out free of charge by the insurance company.
Meditate Mediation is a meeting between a representative of the insurance carrier and the policyholder. A mediator will moderate the meeting and both parties will provide information on the claim. The aim is to find a solution for both sides.
Adjuster This is an expert who is hired to assess property damage. The appraiser will determine how much damage has been done to the property. The appraiser will also recommend the amount to be paid for the damage.

Reasons for rejecting your home insurance claim

Although homeowners insurance is aimed at providing financial protection in the event of a loss from an insured event, there are certain circumstances in which a claim may be refused, including:

  • Insufficient coverage – Household contents insurance does not cover every type of event or cause of damage. Each policy has specific risks covered and it is possible that your claim will fall under an excluded event.
  • Deadline missed – Insurance companies set deadlines when you can make a claim. It is therefore important to report damage immediately after the damage has occurred so that you do not miss any critical deadlines.
  • Not enough documents – Failure to submit adequate documents such as photos, videos or testimonies may result in your claim being rejected. Insurance experts rely on as much detail as possible in making decisions.

Sometimes your insurer won't directly contest your claim. Instead, an agreement could be lower than expected. If so, the same process of reviewing all related records, requesting a re-examination, and engaging an independent third party investigation can be used to contest an offer to settle a home insurance claim. You can also seek advice from a lawyer before accepting a settlement amount.

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