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In What Circumstance Would a Property Insurance Claim Be Rejected?

Jeff Varcadipane

February 26, 2024

When it comes to property insurance claims, insurance companies have a reputation for rejecting claims. However, it is important to note that there is no one-size-fits-all reason for claim denial. Insurance companies will evaluate claims on a case-by-case basis, considering a range of factors specific to the claim. Denials are appealable and, sometimes, the result of bad faith practices.

If you believe the insurance company is unreasonably denying your claim, you need legal assistance from a New Jersey insurance claims attorney. An insurance dispute attorney will negotiate with the insurance company for a fair settlement of your claim. If necessary, they will help file a lawsuit and represent you in fighting the denial.

Below are some common reasons why property insurance claims might be denied. To discuss your denial, reach out to our firm directly.

Failure to Give Timely Notice

An important aspect of the claims process is notifying the insurance company promptly. Your policy likely has time frames when you must inform them of property damage and the potential need for a claim. Timely reporting allows insurers to investigate promptly and assess the situation accurately. If you wait too long, insurance companies might claim the damage should not be covered.

Damages Not Covered

Insurance policies have specific coverage limitations. If the insured files claims for damages not within the scope of the policy, the claim may be rejected. Every insurance policy has terms and conditions of its coverage, such as specific exclusions, which policyholders need to be aware of to avoid unnecessary objections.

Often, homeowners assume their property will be protected after natural disasters, but property insurance coverage can be limited. For example, if a hurricane hits, your usual property coverage might not cover a lot of the damage. The types of water damages covered by traditional policies often do not include flooding, so homeowners must have a separate policy to cover such damage.

Lack of Property Protection

Policyholders have a responsibility to mitigate damages after an incident. Failure to protect the property from further harm may result in rejection.

Policyholders in New Jersey are often required to take reasonable steps to prevent additional losses, a condition often outlined in insurance policies. Failure to do so may give insurance firms a reason to deny claims on the grounds of the “avoidable consequences” doctrine.

Delayed Submission of Proof of Loss Form

Insurance claims typically require the submission of a Proof of Loss form. If this document is not provided in a timely manner, the insurance company may reject the claim. Timely submission ensures a smooth and efficient claims process.

Failure to Cooperate

Insurers often require the insured to actively participate in the investigation. If one does not provide the necessary information or documentation requested by the insurance company, the claim may be rejected. Firms rely on accurate information from policyholders for a fair evaluation.

Damages Below Deductible

Claims for damages that do not exceed the policy deductible may be denied. For instance, you have a homeowner’s insurance policy with a $1,000 deductible. This means in case of damage, you are responsible for covering the initial $1,000 before the insurance company starts to pay. If a kitchen fire in your home causes $800 in damage to the cabinets, the insurance company will not cover any part of the expense because the cost falls below the deductible.

Failure to Undertake “Examination Under Oath”

Insurance companies will sometimes request an “examination under oath.” This is where the insurance company questions a claimant under oath regarding a specific insurance claim. If the insured refuses to comply, it may lead to a rejected claim. Cooperation in all aspects of the investigation is crucial.

Lack of Inventory for Personal Property

In cases involving damaged personal property, the claimant has to provide an inventory. This record provides detailed documentation of the property to prove that the damage indeed occurred. Failure to provide a detailed list may result in claim rejection.

Contact a New Jersey Insurance Claim Attorney Now

Policyholders are supposed to adhere diligently to the terms of their insurance policies and actively participate in the claims process to avoid potential claim rejections. This will ensure a smoother claims experience when needed.

However, when your property insurance claim is rejected, the legal team at Varcadipane & Pinnisi, PC, can help. Our lawyers are well-versed in the laws and regulations and can fight against property insurance claim denials to seek your rightful benefits. Contact us today to book a free consultation.

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