The recent disaster in Rolla, Missouri, has left many homeowners, property owners, and business owners grappling with significant damage. In such times, one of the first steps to recovery is often filing an insurance claim to cover losses. These claims are frequently for property damage through your homeowner, rental, or policy. For businesses, these losses can also include loss of business. Questions on how to file a claim under your insurance should be directed to your local agent and/or the insurance company directly.
During disasters, insurance companies have been known to deny claims to try and protect their bottom lines. The unfortunate reality is our local insurance agents are not part of this decision making process, and while we know they will be fierce advocates for their insureds after a disaster like this, denials can and will happen. This situation is unfortunately all too common, and it can add layers of frustration to an already challenging recovery process. Here are some tips to avoid this situation and what to do if your insurance company denies your claim.
If you have suffered losses resulting from the storms and tornado, consider visiting with the experienced attorneys at Steelman Gaunt Crowley to ensure your legal and financial rights are protected. Contact our experienced, compassionate, and dedicated legal team at (573) 341-8336 to continue the conversation.
What Property and Business Owners Can Do To Protect Themselves When Filing a Claim
To help ensure your claim is not denied, it is essential to take proactive steps to address the situation. Here are some tips on how to respond when facing an insurance claim denial:
Review Your Insurance Policy
Start by reviewing your insurance policy thoroughly to understand the coverage limits, exclusions, and requirements. Ensure that the damage you are claiming falls within the scope of your policy’s coverage. Insurance companies may deny your claim due to a technicality or misunderstanding of your policy. It is important to know what is covered before you file your claim.
Gather Documentation
In many cases, documentation can help clarify the extent of your loss and strengthen your case. This may include photos, repair estimates, expert opinions, or witness statements. Providing clear and compelling evidence of the damage will help prove your claim and can be used to show the cause of damage if the insurance company tries to deny your claim. It is also important to do this early as it can be too late after a denial has occurred.
Record Communication
It is common for insurance companies to discuss claims via the phone and/or in person. It is important to record your communication somehow. That can be done in a variety of ways including: using emails or other written forms of communication, following up verbal conversations with a written summary to the insurance company representative, audio recording your conversations, etc.
Common Reasons for Insurance Claim Denials
Insurance claim denials in the state of Missouri can occur for a variety of reasons, some of which may be based on technicalities, misunderstandings, or policy misinterpretations. Below are some common reasons for insurance claim denials.
Lack of Coverage for the Specific Loss
One of the most common reasons insurance claims are denied is that the damage falls outside the scope of coverage. Insurance policies often have exclusions for certain types of damage.
Failure to Meet Policy Requirements
Every insurance policy includes specific requirements that must be met in order for a claim to be approved. These could include reporting the damage within a certain timeframe, providing proof of damage, or obtaining specific documentation. If these requirements are not met, the insurance company may deny the claim, even if the damage is covered under the policy.
Disputes Over the Cause of Loss
In many cases, insurance companies will investigate the cause of loss before approving or denying a claim. An insurance company may try to deny the damage was caused by a particular insured event, such as the Rolla tornado.
Underreporting or Misrepresenting of the Loss
If the insurance company suspects that the policyholder underreported the damage or misrepresented the extent of the loss, they may deny the claim. It is crucial for property owners and business owners to provide accurate and thorough documentation of the damage, including photos, repair estimates, and any relevant correspondence.
Excessive or Inaccurate Claims
In some cases, insurance companies may deny claims if they believe that the amount claimed is excessive or inaccurate. This can happen when the policyholder submits a claim for damages that are deemed unreasonable or outside the policy’s limits. Additionally, if the damages are seen as not being caused by the insured event, the claim may be denied.
Failure to Pay Premiums, Policy Lapses, or Expired Coverage
Insurance policies require that premiums be paid in full and on time. If a policyholder fails to pay premiums, their insurance coverage may lapse, which could result in the denial of a claim. This situation can be particularly distressing if the loss occurs shortly after a missed payment. Insurance companies will only cover claims that fall within the effective dates of the policy. If a policy has expired or been canceled due to non-payment or other reasons, the insurance company may deny any claims made after the coverage has ended.
What Property and Business Owners Can Do After a Denied Insurance Claim
If your insurance claim has been denied, it is essential to take proactive steps to address the situation. Here are some tips on how to respond when facing an insurance claim denial:
Understand the Reason for Denial
The next step is to understand why your claim was denied. Insurance companies are required to provide a written explanation for their decision. If the reason for the denial is unclear or seems incorrect, never hesitate to request further clarification. This will help you determine whether the denial is based on an error or misinterpretation.
File an Appeal
Insurance policies typically include a process for appealing a claim denial. If you believe that your claim was wrongly denied, you can file an appeal with the insurance company. Your local insurance agent should be able to assist you with this. Be sure to follow the appeal process carefully and submit any required documentation within the specified timeframe.
Consult an Experienced Attorney
We love our local insurance agents, but insurance companies are businesses. Denial decisions will not come from the local agent but the corporate office, and the corporate insurance company will prioritize their bottom line over the interests of policyholders. If your claim has been denied or you are struggling to get it approved, consulting with an experienced attorney can help you understand your legal rights and ensure they are protected. An attorney at Steelman Gaunt Crowley can review your case, identify potential legal issues, and help you navigate the appeals process. They can also help you negotiate with the insurance company or pursue legal action if necessary.
How an Attorney Can Help with Insurance Claim Denials
When faced with a denied insurance claim, it is important to recognize that you do not have to go through the process alone. An experienced attorney can provide invaluable assistance by:
Reviewing the Policy
An attorney can analyze your insurance policy and the reasons for the denial to identify any possible violations of your rights. They can help you understand whether the insurer’s decision was legally justified or based on an error.
Negotiating with the Insurance Company
An attorney can engage with the insurance company on your behalf to negotiate a fair settlement. They can ensure that the insurer follows the terms of the policy and works to ensure that your legal and financial rights are protected.
Handling the Appeal
If you need to file an appeal, an attorney can ensure that all necessary steps are taken in a timely manner. They can assist with gathering the required evidence and submitting your appeal to the insurance company.
Litigating the Case
If negotiations or appeals do not lead to a satisfactory outcome, an attorney can help you take legal action against the insurance company. A lawsuit may be necessary to recover the benefits owed to you under the policy.
Providing Peace of Mind
An attorney can offer peace of mind during an incredibly stressful time. With their guidance, you can feel confident that your case is being handled professionally, allowing you to focus on your recovery.
Contact an Experienced Rolla, Missouri Attorney To Ensure Your Legal and Financial Rights Are Protected Against Insurance Companies
The aftermath of a disaster like the one in Rolla, Missouri, can be overwhelming and result in catastrophic losses. Unfortunately, dealing with insurance claim denials oftentimes only adds to the stress. However, it’s important to remember that insurance companies are obligated to act in good faith and honor their contracts. If you believe your claim was wrongly denied, do not hesitate to seek legal assistance to understand all of your legal rights.
An attorney with experience in insurance claim disputes can help you navigate the complexities of the claims process, ensure that your rights are protected, and increase your chances of receiving the compensation you deserve. At Steelman Gaunt Crowley, we are committed to helping homeowners and business owners in Rolla and across Missouri fight back against unjust insurance denials. Contact our experienced Rolla, Missouri legal team at (573) 341-8336 to continue the conversation and learn more.
