How Do I Know if My Insurance Claim is Covered?

When you purchase your home, the financier requires you to buy a home insurance policy for your property, covering it against fire and water damage.

You don't have any say in the matter, or the financing organization will refuse to issue you a mortgage. Purchasing insurance for your car is a grudge purchase, but we all have to do it if we want to drive lawfully on the road.

While many of us are just happy to get the insurance policy and get it over with, we often don't realize what we've involved ourselves in until it comes time to file a claim. It's typical that when you need your insurer the most, they deny your claim.

Insurance companies are businesses, and they don't like paying out their clients; they are just happy to collect premiums and reject claims wherever they can. Insurers use "adjusters" to assess the damage to your property after receiving your claim.

The insurer has a team of in-house adjusters, or they might contract to a private loss adjustment firm if they are experiencing high volumes of claims, like in the wake of a hurricane.

These adjusters don't work for you; they work for the insurer. Their year-end bonuses often rely on how many claims they throw out during the year.

To ensure that you get a fair assessment, you'll need to confirm your insurance policy has the cover you need for your property. Here are some points to consider in your policy to ensure you have the right cover for your claim.


No Coverage

If your insurer lists that you have no cover for the event causing damage to your property, you don't have a claim.

Events that create situations of "force majeure" or "acts of God," like floods and earthquakes, typically require a separate policy for cover.

Service Life and Normal Wear and Tear

The insurer may reject your claim based on the assessor's evaluation of your property and the events leading to the claim.

If your assessor decides that the problem occurred due to natural wear and tear on your car, home, or any insured asset, the insurer will likely reject your claim.

Lack of Maintenance

Failing to maintain your home or vehicle could also result in the insurer tossing out your claim.

If the assessor determines the cause of the problem is a lack of maintenance on your behalf, they will likely reject your claim.

Defective Materials and or Workmanship

If a contractor fails to meet construction regulations and guidelines when building a structure, like a wall or your home, your insurer will reject your claim.

Failing to Disclose Information

The insurer may reject your claim if you fail to disclose all the information surrounding your property and the claim.

For instance, if you have a bad credit record and outstanding debt, the insurer may reject your claim stating that they think you are using the claim to settle your debts.

Late Notifications

You have 30-days to file your claim with your insurer after the event occurs, causing damage to your property. Failing to meet this deadline will result in the insurer denying your claim.

No Financial Interest

The policy must note all of the parties on the policy to get cover. If you don't have a financial stake in the insured asset, you cannot claim.

Unpaid Debit Orders for Your Premiums

If you haven't paid your premium for the month, your insurer will cancel your policy, and you won't have any cover.

Placing a stop order on the debit for your insurance policy immediately voids your cover. However, if the policy payment returns due to insufficient funds, you'll have to make the premium payment before the insurer starts evaluating your claim.

Dishonesty, Misrepresentation, and Criminal Intent

As you can imagine, any of the above will cause the insurer to reject your claim, provided they can prove it. Some criminal intent may also land you in hot water with the law, resulting in fines or jail time.

Denial of Cover

If the insurer thinks your claim is fraudulent, they will reject it. Misrepresentation and deception will cause the insurer to cancel your policy immediately, and you'll find it hard to get cover from any other insurance company.

Wrapping Up – Hire Florida Public Adjusters

If you're having trouble navigating your claim, hire a public adjuster. Unlike a company or independent adjuster, the public adjuster works for you, not the insurer.

Hiring a public adjuster ensures that you have the best chance of the insurer processing your claim and paying you out.

United Claim Clinic Mission Statement

At United Claim Clinic our number one mission is to educate consumers about the insurance claim process. Sometimes we can equip people with the knowledge to navigate a claim by themselves. For more complicated claims, we are here to be an advocate for the insured to see that the carrier fulfills their obligation to get your property and life back to normal.