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Why was my claim denied?

Home Insurance

By Viola Wallace | October 3, 2018

You’ve heard the saying “A man’s home is his castle��?. As a homeowner you know that feeling of attachment whether your home is a regal castle on an acreage or a small condo that’s bursting at the seams. Your home is an extension of yourself and this bond only gets stronger over time. This is why when your home is damaged or invaded the sense of personal injury is very strong. A successful insurance claim will go some way towards softening the blow but what if your claim is denied? This can be devastating emotionally and financially. There are number of reasons why some insurance claims are denied or payouts are limited (a partial denial).

Claim can be denied due to time limits.

Time can a significant factor in the denial of insurance claims; delays in filing the initial claim will violate the conditions of your policy.It makes sense to check the conditions of your policyregarding time limits when you first take it out since the immediate fallout from a major burglary or ‘act of God’ may well push insurance to the back of your mind.

Don’t sit back yet just because you’ve filed a claim on time. Once your claim is in progress not providing further information to your insurer in a timely manner can lead to your claim expiring. Calling your insurer regularly is one way of ensuring that you don’t miss any vital communications. Better yet work with an insurance brokerthat’s proactive and follows up on your case. That way you save yourself lots of time.

Claim can be denied due to violation of your policy.

Every policy has “rules” that need to be followed in order to ensure it stays in force. For example m ost homeowners’ insurance policies state that you must not leave your home unattended for longer than 48 – 72 hours.  Doing so is a violation of the policy. The majority of claims denied due to this exclusion are not cases of burglary but cases of damage caused by burst pipes during the winter. Having someone check on your home while you are away is good practice if you want to avoid having your claim denied.

Other violations include criminal activity. Criminal activity can affect your insurance claim in different ways:

  • Failure to inform your insurer of past criminal convictions – of the policy holder and any permanent residents – can invalidate your policy and therefore any claims made under it.
  • Any criminal actions during the incident for which a claim is made can invalidate your policy.
  • Conducting criminal activity in the insured home will also void your policy.

Misrepresentation is another violation of your policy. Misrepresenting the value of your home and its contents or falsely claiming that maintenance has taken place or security measures put in and falsely claiming that your home is not used for any commercial activities are all grounds for invalidating your policy which will lead to your claim being denied.

You can learn more aboutwhat can void your policy here.

Claim is denied due to limitations on your coverage.

This is where understanding your policy’s coverage and policy limits is really important. Each insurance company and “level” of home insurance offers different coverage and policy limits. Endorsements or add-ons extend your coverage and limits to protect your home against certain perils like flooding.

For example things like flood insurance (known in the industry as overland water coverage) and sewage backup coverage are generally endorsements meaning they’re not covered as part of a standard home insurance policy.

Another thing not typically covered is a vacant home. You need a specialized insurance policy to protect a vacant home. This is an excellent reminder tocommunicate with your brokerwhen things change.

High value items like artwork and jewelry may be worth more than your policy covers. Understand your policy limits – you can take out extra protection for high-value items to ensure they’ll be protected.You can learn more here.

Partial denials are often because of policy limits and coverage. For example say you have sewer back up but not overland water insurance. Both damage your home. You’ll get some help with the damage caused by sewer back up but not for the damage caused by flooding. Alternatively your policy limits on your contents could be lower than the worth of all of your belongings. Unfortunately you will only get the maximum amount whether or not you can replace everything.

Again the key here is to know what your policy says.Talking to your brokeris a good place to start. They can read understand and explain your policy to you in clear terms. With that knowledge you can save yourself from the disappointment of a denied claim.

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