9 Tips for Winning When Your Homeowners Insurance Company Denies Your Claim

Why you shouldn’t give up when your homeowners insurance company denies your claim: Internet ScamBusters #143


Internet ScamBusters™

The #1 Publication on Internet Fraud

By Audri and Jim Lanford

Copyright © Audri and Jim Lanford

All rights reserved.

Issue #143


Hi Everyone,

Today we focus on a common consumer complaint that is especially relevant, given

all of the destruction from Hurricane Katrina: what to do when your homeowners

insurance company denies your claim.

We’ve been planning to deal with this topic for a while. And with millions of

homes damaged or destroyed by Hurricane Katrina, many people are going to be negotiating

with their homeowners insurance companies to get their homes repaired or rebuilt

in the not-too-distant future.

Plus, these tips are also useful when other types of insurance claims are denied.

Before we get going, if you haven’t yet seen our article on Hurricane Katrina

scams, we suggest you check it out. Many different types of Hurricane

Katrina scams are already making the rounds — find out what they

are, how to protect yourself, and how you can help. Visit now.

OK, let’s begin…


9 Tips for Winning When Your Homeowners Insurance Company Denies Your Claim


If you’ve made a claim on your homeowners insurance — and it’s been denied –

don’t give up. There ARE some things you can do to keep the claim active and try

to reverse the decision.

This will most likely be especially true for the next year or two as insurance

adjusters and company representatives are especially busy.

Here are 9 useful tips for winning your homeowners insurance claim:

Tip 1 — Don’t assume NO is final

Did you know that less than 1% of claimants query the decision when a claim is

denied? Yet, over 50% of those who do fight back get results.

So, you’ve got a good chance of winning if you fight back.

10% of claims are unjustly denied, so if you are aware your claim is legitimate,

and you’ve not indulged in any creative claiming, you have a good chance — even

if they’ve said no.

It’s also a fact that most claimants who query their claim end up with a better

settlement… or having a denial reversed!

Tip 2 — Get It In Writing

Insist on a review of the case, and a written comprehensive explanation of the

reasons for rejecting the claim. It’s surprising how many insurers don’t give

their "no" in writing, and it may be a legal requirement where you live.

Tip 3 — Now Check Your Policy

Once you have it in writing, check the reason for denial against your policy.

Look for ANYTHING that doesn’t add up or make sense. Then query this in writing,

referring to quotes from the policy where necessary.

Many claims come down to interpretation of the policy, so a good case explaining

why you believe your claim is valid may lead to reconsideration.

Tip 4 — Never Accept Claims Process Errors

The insurer will have a claims process or filing process. For example, you need

to file the claim within a certain window of time. The insurance company may deny

your claim (or try to) just because you filled in a form incorrectly, or didn’t

file within the designated time limit.

An insurance company cannot usually refuse to pay a claim that is otherwise valid

just because of a claim filing error in most legal jurisdictions, unless it can

show that your error either harmed the company, or prevented it from investigating

adequately.

(BTW, each country and state has its own regulations about claims and responding

to them, so do check your own location’s rules and regulations before implementing

the ideas on this list.)

Tip 5 — Try Asking Your Agent For Assistance/Advice

This isn’t frankly very likely to do any good, but you never know until you try.

They may be able to help, or to direct you to the right people to contact for

the following tips…

Tip 6 — Call The Authorities

In the US, call the State Insurance Department or the Department of Insurance.

In the UK, the Insurance Ombudsman. Wherever you are, check first with the legal

authority that governs insurance about what your rights are.

Tip 7 – Secure An Agent

Actors and writers use agents to represent them in the marketplace. Insurance

companies also use agents so they don’t have to deal with you personally.

Consider hiring an agent to represent you in the claim. Good agents will pay for

themselves in major claims.

Many people aren’t aware that these agents exist. For example, in the US they

may be called "Professional Loss Consultants" and charge a fee of about

10-15% of your claim. They know how to deal with insurers and claims, and may

increase your claim for you if they are brought in early enough (which may cover

their fees). If you’ve already made a claim and lost, they may still be able to

help.

But beware of "no win no fee" arrangements: before signing, attractive

though they may sound, check what the fee WILL be if you win — and who will pay.

Otherwise you may find your winning claim is eaten away by the agent’s legal costs.

Tip 8 — Consider A Lawyer

Now this tip is a two-edged sword. Insurance companies tend to sit up and take

notice when lawyers are brought in. On the other hand, once a lawyer or attorney

is hired, you may find that the insurance company and your own agent (if you have

one) will only be able to communicate through the lawyer, which can be costly

and time-consuming.

Tip 9 — Be Persistent

Telephone the company regularly — every 2-3 weeks. Be polite, but be persistent.

Keep asking for the person’s supervisor or manager if you don’t get a suitable

response.

Log all phone calls, with the date, time and names of the people you spoke with.

Follow each call up with a letter explaining the conversation and the issue you

have with it, and ask for a written response within 14 days. Then call again if/when

you don’t get a response.

It goes without saying to also keep copies of all letters you send, and send everything

by certified mail with return receipt.

We obviously can’t guarantee that these tips will get your claim paid out, but

they certainly can help.

And remember, less than 1% of people query a rejected claim, yet over 50% of those

who do get somewhere!

We hope these homeowners insurance tips were useful — we’ll see you next week.