How-to-Dispute-a-Denied-Insurance-Claim

How to Dispute a Denied Insurance Claim

It’s bad enough to suffer serious property damage, but if your insurance company refuses to pay your claim or presents you with a lowball offer, it can leave you feeling helpless. The good news is, you have options. If you’re not happy with the result of your claim, there are several steps you can take to dispute it. Here’s how to get started.

1. Review Your Denial or Settlement Offer

The first step is to understand why your claim was denied, or the basis for the settlement you were offered. You should receive a formal letter explaining the insurance company’s decision. This letter should provide the specific language contained in your insurance policy that supports the reason for their denial. Carefully review this letter and compare it to your understanding of your coverage.

There may be a legitimate reason for your denial. For example, if your premium wasn’t paid or the type of loss you experienced is explicitly excluded from your policy, then, unfortunately, there isn’t much more you can do. However, if you’ve reviewed everything and still believe your loss should be covered or you’re entitled to more, then you may have a basis for an appeal. In addition, if you feel that the reasoning provided was ambiguous or unclear, you can reach out to your insurance company to ask for clarification.

2. Contact a Public Adjuster

Convincing an adjuster to reverse a denial is no easy task. If you’ve contacted your insurance company and did not get the outcome you were hoping for, the next step is to contact a public adjuster.

While the claims adjuster who initially reviews your case works for the insurance company, a public adjuster works for you. This professional will provide an independent assessment of the damage, which may or may not match the insurance adjuster’s findings.

Often, the public adjuster’s findings can substantiate your right to a higher settlement. In some cases, they may also be able to note aspects of your policy that may have been overlooked. For example, if you’re entitled to “full replacement value,” you may deserve an even higher settlement.

3. File an Appeal

Typically, a public adjuster will “take the reins” when it comes to filing your appeal. This allows you to step away from the tug-of-war with your insurance company and hand the case over to an experienced professional.

The adjuster can resubmit your homeowner’s insurance claim and act as your advocate while negotiating with the insurance company. Not only can this be a major stress-reducer, but it can often help you get the highest possible settlement allowed by your insurance coverage.

4. Continue the Fight

If the insurance company continues to deny your claim and both you and your adjuster believe you are owed compensation, you may consider filing a formal complaint with your state’s insurance board. Once they’ve received all of the information, they will investigate your denied claim.

As a last resort, you can contact an attorney who will work with you to determine your options for legal recourse. If your attorney believes your claim was unfairly denied, he or she can legally represent you and assist you in taking further action to fight for compensation.

Consult with Our Public Adjuster

When you’re dealing with a denied insurance claim, there is significant value in working with an experienced professional public adjuster. Coast2Coast Public Adjusters is committed to supporting our clients throughout the entire appeals process. We’ll provide a fair and impartial assessment and advise you on the next steps for dealing with your claim denial. Contact us today to request a consultation.

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