How to Dispute a Homeowners Claim

Three Parts:Preparing Your CaseNegotiating with the AdjusterTaking Your Insurer to Court

A natural disaster or other emergency that damages your home or personal property is traumatic enough. However, the situation becomes even worse if your homeowners' insurance company denies your claim. Although it may take some time and effort, there are steps you can take to get the insurance company to give you the money you deserve for your loss.

Part 1
Preparing Your Case

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    Study your policy. Read your policy carefully in light of the reasons your claim was denied and make sure the damages actually are covered by your policy.
    • Many policies have deadlines for filing claims, and your insurance company reserves the right to deny your claim if it isn't filed within a certain amount of time after the event that gave rise to the claim.[1] Look for these time periods and deadlines and make sure you filed your claim within the stated limits.
    • Take notes when your claims adjuster makes any comments about your coverage. Your claims adjuster interprets your policy to determine how much money your insurance company needs to pay on your claim, but don't be afraid to question her interpretation or get another opinion.[2]
    • Compare the reasons your claim was denied to the language in your policy. Claims typically are denied for lack of coverage, which means you asked for damages that your policy didn't protect you against.[3] For example, if your home is destroyed by a hurricane, your insurance policy may cover the structural damage but not the interior water damage.
    • Your claim may have been denied by someone in the company who didn't know your policy or didn't review your coverage carefully before issuing the denial. It also is possible that your claim was denied because of a clerical error.[4] These simple errors may be unlikely, but you should still rule them out.
    • Double-check how the insurance company classified the loss and make sure it's accurate. The insurance company may have classified the damages as something not covered by your policy, when your policy would have covered them if they were classified another way.[5]
    • For example, suppose your home is damaged in a hurricane, and the hurricane causes flooding. If you don't have flood insurance, your insurance company may deny your claim by stating all the damages were flood-related damages, when in fact many of them were caused by the hurricane itself.
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    Document everything. Keep accurate records of your home and inventory all property within it that was affected by the incident that gave rise to your claim.
    • Keeping an up-to-date home inventory is the easiest way to accurately document everything damaged or missing.[6] For example, if your home is burglarized, it can be difficult to remember all the things in a room after those things are missing. You may not remember something until weeks or months later.
    • In the case of a total loss, you may have to recreate a list of all your belongings from memory. In the stress and aftermath of such a devastating loss, it can be difficult to remember everything you owned, particularly things in storage or that you didn't use very often.[7]
    • If your claim involved loss due to a crime such as theft or vandalism, get copies of your police report and follow up with the police regarding the charges.[8]
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    Take photos of all damage. Take photos of any damaged property as soon as possible after it is discovered.
    • Walk around inside and outside your home with a camera or your cell phone and take photos of everything so you have a record of all damages.[9]
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    Avoid making permanent repairs immediately. Except for repairs that are essential for you to live in your home, you shouldn't repair or replace anything in your claim until the dispute is resolved.
    • Although you may need to make some temporary repairs to make your home safe or protect it from further damage, it's important to preserve the scene so your claims adjuster can see the extent of the damage.[10]
    • For example, you might place a tarp over a hole in your roof to prevent rain from getting into your home and causing further water damage.
    • Keep receipts for any repairs you do make and add the amounts to your claim.[11]
    • Make sure you have at least two estimates for any repairs before you have any work completed.[12] Your insurance company may deny your claim or only pay part of your claim if you don't have several estimates to prove you didn't overpay for the repairs.
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    Write out an account of what happened. Write down everything that happened leading to the damage to your property, especially any steps you took to mitigate the potential damage.
    • Also keep a running record of notes when you talk to anyone regarding your claim or the event that led to your claim. This will become especially important if you end up talking to more than one claims adjuster over time.[13]
    • Contact any witnesses who would be willing to back up your story, or who saw the event take place.[14]

Part 2
Negotiating with the Adjuster

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    File an appeal of the initial report. Many companies give you the opportunity to appeal the initial decision made by the adjustor.
    • When you file your appeal, include all documentation you have supporting your claim, including any photos of the damage, written documents, receipts, and statements from witnesses.[15]
    • Include documentation of inspections and maintenance to prove you kept up with your end of the bargain and maintained your home correctly and kept up with any safety precautions.[16]
    • For example, if your home was destroyed in a fire, produce any evidence you can that you had smoke detectors or other alarm systems in place and they were functioning properly.
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    Contact your state's department of insurance. Your state's department of insurance regulates the insurance companies operating in your state and has resources to assist you in resolving claim disputes.
    • The state's department of insurance has staff on hand who can answer questions about the claims process and offer advice on pursuing your claim.[17]
    • Your state's department of insurance also can inform you of your rights under various state insurance laws. The laws vary among states, but most states have laws that require insurance companies to deal with policy holders fairly, and provide standards for how insurance companies must handle claims.[18]
    • For example, most states require insurance companies to provide a reason your claim was denied.[19]
    • These insurance departments also investigate complaints and can help you resolve your dispute. If you have reason to believe the denial of your claim violated state laws or regulations, the state insurance department will look into the matter.[20]
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    Write a letter to a manager. If you can't get anywhere with the adjustor, you may be able to write a formal demand letter to someone higher up.
    • In your letter, explain the event that gave rise to your claim, the reasons you were given for the denial of your claim, and why you believe that decision was in error.
    • Include documentation or other evidence that backs up your argument, or indicate that you already have made that information available to the company. Include your policy number, your claim number, your current contact information, and any other information you think would help the person resolve your dispute more quickly.[21]
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    Hire your own adjuster. A public adjuster can review your claim and your damages and make an independent assessment to present to your insurance company.
    • Contact the National Association of Public Insurance Adjusters to find a public adjuster, or ask an insurance attorney for a recommendation. It's important to confirm that any adjuster you hire is licensed to work in your state and that her license is in good standing.
    • Rather than simply hiring the first adjuster you find, interview several potential adjusters so you can find out more about their credentials and experience and get references.[22]
    • Find out if there are particular types of claims in which each adjuster specializes. For example, if your home was burglarized, you don't necessarily want to hire an adjuster who specializes in hurricane damage.
    • Keep in mind that you will have to pay a fee for the adjuster's services.[23] Although this makes sense for larger claims, hiring a public adjuster might not be in your best interest if your damages are relatively small.
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    Consider alternate dispute resolution. It may be possible to reach a better settlement using a neutral and objective third-party mediator.
    • Independent mediation and arbitration companies provide dispute resolution services using procedures that tend to be more informal and less confrontational than the court process.[24]
    • Mediation is relatively fast, and cheaper than filing a lawsuit. However, the settlement you reach through mediation may be less than you would've been able to get through the trial process.[25]

Part 3
Taking Your Insurer to Court

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    Consult an attorney. If you are unable to resolve the dispute with your insurance company to your satisfaction and want to sue, you should consider hiring an attorney.
    • If you have a relatively small claim – less than $10,000 in most states – you also might consider filing in small claims court. Small claims courts use simplified processes to resolve claims and you typically don't need to hire an attorney.[26]
    • Insurance policies are contracts, and insurance claims may involve technical legal issues an attorney could help you more easily understand.[27]
    • If you have a larger claim, or if you are intimidated by the insurance company, you might find you feel more comfortable having an attorney to represent your interests. Plaintiff's attorneys filing insurance claims typically work on contingency fees, taking a portion of your settlement if you win your claim rather than requiring money up front.
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    File your complaint. After you've talked to your attorney, she will draw up the complaint to initiate your lawsuit in court.
    • Your lawsuit may allege that when the insurance company denied your claim, it breached the contract to pay you money if you had certain types of losses or damages to your home. Depending on your state's insurance laws, you also may argue that the company violated a consumer protection law or a "good faith" law.[28]
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    Participate in discovery. Before trial, you must share evidence and information with the other side during the discovery process.
    • Written discovery can include requests for documents or answers to written questions known as interrogatories.[29] For example, you may ask the insurance company to give you a complete copy of your insurance policy file and claim file, including notes from the claims adjusters.
    • Discovery also includes depositions, which are interviews with parties or witnesses held under oath with a court reporter who produces a transcript of the proceeding.[30]
    • At any point during discovery, you may receive an offer of settlement from the insurance company.
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    Continue your case. If you still aren't able to settle your claim with your insurance company, the case will proceed to trial.

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