As we go through the first weekend of some serious football, the word blindsided starts getting tossed around a bit. This word also applies when you’re talking about insurance claims and particularly denial letters. Just the word DENIED itself is definitely a momentum killer. When it comes to an insurance claim, receipt of a denial letter immediately impedes any progress. Although some denial letters are definitely warranted, others are based solely on the adjuster’s opinions and have no factual support for the denial at all.
In the world of insurance, adjusters and insurance companies interpret the policy language in their favor if ever there is any wiggle room. The general public are not experts at reading and interpreting policy language. Sometimes a denial will result from a simple misunderstanding of the origin of the damages, while other times the denial comes from manipulating the facts in favor of the insurer. This is exactly why it is important to hire a claim professional on your side to review the cause and damages, and then relate those to the terms and conditions of the policy.
If you find yourself in the middle of a denial situation, it is important to make sure that you have all the right documentation. You may also need an expert to determine the exact origin of the damages and the appropriate chain of events. If the denial is the result of a prior claim, you definitely will be required to provide receipts and photographs that depict the work that was performed to replace and repair the previous damage. If the denial is a question of coverage as a result of questioning the cause of the damage, then a claim professional on your side is going to be your best option.
If for any reason you believe that the denial is possibly a grey area or the human element of processing the claim could have been a factor in the outcome, reach out to a public adjuster or other claim professional to further investigate the loss to protect your interests.