Homeowner's, Commericial Property, and Business Loss

What should I do if my Insurance claim is denied?

You do not have to accept a denial from your insurance carrier as the final word on your Insurance claim; however, if you decide to pursue your claim further, after the insurance carrier has denied it, you must not waste any time doing so, because your policy may contain certain deadlines for pursuing your claim.

How should I proceed?

Prior to making an appointment with the attorney, it is important that you prepare for the consultation by gathering and organizing your evidence in a place where you can readily secure it.

What evidence will I need for the attorney to review?

The following materials will provide valuable aid to the insurance attorney in making an informed determination whether or not your case can be taken to the next level, and will minimize the necessary preparation time if a lawsuit is to be filed:

1.  Get the denial in writing. You have the right to a written denial letter from the insurance company which includes disclosure of the basis for denying your claim. This letter is most important to the attorney if your case is to be pursued.

2.  The terms and conditions of the policy. This is not just the sheet that discloses your coverages, or the promotional materials which you receive from your insurance carrier, but the actual terms and conditions of the policy, which should have been provided to you when you signed up for the policy. If you do not have a copy, make a written request to the insurance carrier for a copy. Usually, the best person to write would be the one who denied your claim.

3.  Damages. Be prepared to provide proof of ownership, as needed, and document the items that you lost as well as what it will cost to replace them.

  • Make a list of the items that were damaged or cannot be found and the replacement value of those items.
  • Provide photographs of all damages and damaged items.
  • If possible, locate photographs of those items in their undamaged condition. Family snapshots are a good source as many items show up in the background.
  • Provide copies of receipts for purchase of the items that were damaged or missing, if possible.
  • Provide copies of all estimates for repair or replacement of the damaged items.
  • Provide copies of receipts for any temporary repairs that you may have had to make in order to prevent further damage.
  • Document, in writing, all conversations with the insurance company and adjusters.

Damages specifically for Business and Commercial Losses.  Be able to document your loss by providing sales receipts, inventory lost and monthly/quarterly income statements. Your accountant, bookkeeper or CPA should be able to assist with these items as it will be necessary to prove these losses.

4. Get copies and transcripts of any statements you have given to insurance adjusters. The familiar phrase, "Anything you say can and will be used against you," also applies in cases, particularly when statements have been given, either in writing or over the telephone, to insurance adjusters. If you have given any statements, you should write a letter to the insurance adjuster and request written copies of any and all written statements which you have given and transcripts of any and all oral statements, as well.

5. Witnesses to your loss. Be prepared to provide the names, addresses and telephone numbers of important and reliable witnesses such as your friends, relatives or co-workers, who might provide important information about your insurance claim.

What should I do after I have assembled my evidence?

1.  Once you have assembled your materials, schedule an appointment with an attorney experienced in handling private insurance claims and coverage disputes.