There are many reasons insurance companies justifiably deny fire insurance claims. But that doesn’t mean all fire claim denials are justified.
If you’ve had a fire, and your insurance company denied your claim, there are several things you should do immediately.
Review the Denial Letter
You will receive a letter explaining exactly why your insurance company denied your claim. Compare the details in this letter to the coverage details in your insurance policy.
- Be sure you understand the language in both the denial letter and your policy. If it is clear your coverage was not adequate to cover your loss, or if the peril was excluded from your policy, there is no cause for further action.
- If you disagree with how your insurance company interpreted your coverage to deny your claim, or you reasonably believe your policy provides coverage for your loss, contact your agent or insurance adjuster to present your position. Make certain you document every contact, including the dates, times, person/people you speak with, what is communicated, and any next steps required, by whom, and by when. Meet every deadline.
Build Your Strongest Case
Sometimes no amount of logic or determination changes the outcome of a denied fire claim. Once your claim is denied, the burden of proof is on you, the insured, to prove your loss. Build a strong case that includes your:
- Detailed evidence of the loss.
- Policy information that shows the loss should be covered.
- Efforts to have your denied claim reviewed.
- Rebuttal to your insurance company’s denial.
- Justifications for your rebuttal.
- Supporting documentation and proof.
Work Your Way Up the Chain
As frustrating as things may get, you have to be your own advocate. And you may have to fight harder than you’ve ever had to fight in your life. But:
- If, after you and your insurance company argued your different interpretations of your coverage, and you continue to reasonably believe your loss is covered under the terms of your policy, start moving up the chain, presenting your side to your insurance adjuster’s and agent’s supervisors, managers, directors, etc.
- Again, maintain meticulous documentation of each and every contact. Even if you don’t get through to anyone, note every attempt to contact, the date, time and result. Keeping your notes, communications, copies, and other proof organized will help you as you advance your argument and push your denied claim forward.
File a Complaint With The Ombudsman
If you still believe your loss should be covered, and your insurance company continues to delay and deny your claim, you can file a formal complaint with the relevant Ombudsman.
- This process will automatically trigger a review of your denied claim, your efforts to reverse the denial, and your evidence and reasoning for requesting the reversal.
- The insurance commissioner will review each complaint based on its own merits and order the insurance company to respond appropriately.
- Before filing a complaint, you must try all the available remedies to resolve your claim. Your insurance policy will outline the required steps specific to your fire insurance claim.