Contrary to the hundreds of commercials running every single day in America, insurance carriers are NOT on your side. Even if you really like your broker or have had a good experience with your provider in the past, the truth is that all insurance companies care about one thing—and it's not you. Insurers simply do not make profits by paying out, and will always try to deny claims if they think they can get away with it.
Look for These 7 Key Phrases in Your Insurance Claim Denial
If an insurer intends to deny coverage, it is obligated to provide a specific reason why coverage was denied. You absolutely need to speak with an insurance attorney if you receive a letter from your insurance carrier that contains ANY of the following language:
- "The damage is cosmetic." Damage to the appearance of a property is not necessarily minor, especially for businesses. Cosmetic damage can also be a sign of damage beneath the site, such as missing roof tiles that allow water to enter the structure.
- "The damage amount is under your deductible." Insurers may lowball the cost of repairs, essentially telling you that paying out of pocket will be cheaper.
- "The damage is caused by wear and tear." Insurers may cite "wear and tear" to deny claims for older properties, even if they are in good shape.
- "Lack of maintenance caused the damage." Insurers often improperly cite maintenance defects as a cause of damage, but accurate and thorough maintenance records can help dispute an insurance denial.
- "Improper installation caused the damage." If changes have been made to the property, an insurer may attempt to blame the damage on manufacturing or installation defects.
- "The damage was not caused by a covered peril." Policyholders are given the benefit of any ambiguous language in a policy, so if the policy is unclear about which perils are covered, the insurer may be compelled to cover damages.
- "The damage occurred outside of the policy period." Insurers may attempt to blame a denial on pre-existing damage. However, most insurance companies will inspect the property prior to selling the insurance policy—and if the inspection shows that the property was in acceptable condition, the insurer may be forced to issue payment.
Insurance companies have a legal duty to act in good faith when handling customer claims, including performing a careful investigation of each claim and issuing timely payments. If you are having trouble getting the insurance coverage you paid for, the Voss Law Firm can help. Simply fill out the form on this page to get your questions answered by one of our experienced insurance claims attorneys, or learn more about filing a claim in our book, Commercial Property Owners Must Read This BEFORE Filing an Insurance Claim.
If you have any questions contact us online or call us at (281) 549-8911.