Denials and short checks
When the letter says no
A denial is the insurer's reading of your policy. Another reading is possible, and the policy is the place to settle it.
Most denial letters give a short reason and a section number. We pull the whole policy, including the endorsements that change it, and set it beside the adjuster's report, your photos and the repair bids.
Sometimes the insurer is right, and you will hear that from us on the first call. When it is wrong, the letter that goes back to it names the policy language, the facts and the amount.
Reasons on the letter
What denials usually say
Each reason has a way to be checked. These are the ones we see most.
Wear and tear
A roof or pipe is called old, not damaged. We compare the age of the part with what actually failed and when.
Late notice
The insurer says it was told too late. The policy's own notice terms decide, and so does what the insurer knew and when.
Excluded cause
Water, mold or wind is said to fall under an exclusion. Exclusions have exceptions, and the wording matters.
Prior damage
New damage is blamed on an older problem. Dated photos and repair records settle more of these than people expect.
Missing paperwork
The file is called incomplete after you sent it twice. We rebuild the paper trail and send it once, with proof of delivery.
A short check
The coverage is admitted but the number is low. Scope, pricing and what was left out are all open to challenge.
About denied claims
Should I send the insurer more documents on my own?
Send what it asks for, in writing, and keep a copy and the date. Before you send a narrative of what happened, talk to someone who has read the policy.
Can I dispute only part of what was denied?
Yes. A claim can be partly accepted and partly denied, and each part can be argued on its own terms.
Will the insurer drop me for disputing?
Disputing a claim is not the same as making a new one. What a company may do about renewals depends on your policy and the law that applies, and we can look at that with you.