Denied After a Natural Disaster? How to Appeal a Rejected Insurance Claim

After a natural disaster strikes, the aftermath and financial and emotional burden is likely to be daunting and leave you feeling stuck. Your home or business may be in complete ruins, but you have the comfort and peace of mind knowing you’re insured. Many turn to their insurance policies for a sense of relief, however not all policyholders are covered for such disasters and their claims may be denied for a particular reason, which in turn, can create further frustration, disheartment and panic.

If you’ve experienced a denied insurance claim, know that you’re not alone. This is not the end of the road, there are still options to appeal a rejected claim and how experts such as Harris Balcombe can help with expert support to strengthen your claim which can help significantly improve your chances of a successful outcome.

When a policyholder files an insurance claim following a natural disaster, they rightly expect to be paid out for the damages done and losses incurred. However, this isn’t always the case unfortunately due to various reasons. It’s important to understand the reasons for claim denials in order to rebuttal your claim.

Firstly, policy exclusions. This is the primary reason for an insurance claim being denied. Often policies have certain clauses that may exclude certain damage types from natural disasters, such as a flood or an earthquake. It’s therefore to fully understand every section of your policy and the fine print to ensure you’re comprehensively covered. Exclusions and stipulations vary from insurer to insurer and policy to policy, so never expect your policy to cover you without carefully checking.

Secondly, policyholders may fail to present accurate documentation or proof of the damage post a disastrous event. This is to substantiate your case with full evidence of the loss and damage caused.

Thirdly, a claim may be denied because it was filed after the claim’s deadline. Policies may stipulate how long after the event a claim needs to be put in for it to be considered. If you miss the deadline to submit your claim, you risk forfeiting your right to challenge the denial, therefore it’s crucial to always act efficiently.

Don’t despair after receiving a denial for your claim, despite your frustration and fears. There are necessary steps to follow to help address and fix this situation. Ensuring you act in a timely manner and strategically can make or break the situation.

Preparing your appeal letter is the next most important step in the process. It needs to be concise, yet comprehensive, including all relevant details. This letter should directly address the reason why your claim was denied and focus on this solely. For example, if your claim was denied because you failed to substantiate your claim without enough evidence, then prove in your appeal letter that you can indeed have everything necessary. If it was denied due to an exclusion, review your policy carefully to check if it was excluded, and if not, clearly state where in the policy it is written. Often, the language may seem ambiguous, so a strong argument can be made that this exclusion is not relevant to your claim.

It’s important to note that there is not a one-size-fits-all approach when it comes to appealing a claim, as each policy differs. Do not be aggressive or use confrontational language in your appeal letter as this will not help the open communication process with your insurer.

Navigating the complexity of the insurance process can be overwhelming, especially when a claim has been rejected for a particular reason and during the aftermath of a disaster. Many people turn to professionals at this point as they are at a dead-end where to go next.

A loss assessor can help with the load from any point in the claim process, especially after you’ve received a denial letter. This is valuable as you gain an ally from the outset - someone firmly on your side to guide you through the process. The primary role of a loss assessor is to represent the policyholder from the moment they are instated. They will use their expertise to handle every aspect of the process, from assessing the damage, preparing the necessary documentation, to negotiating with the insurance company for the greatest possible settlement.

A loss assessor understands all the intricacies and nuances in a policy and will know best what evidence and supporting documents are needed to help fight the denied claim. They can communicate effectively with your insurer on your behalf and do all the heavy lifting with your best interest in mind.

When appealing a denied insurance claim for a natural disaster, it’s important to ensure you follow the necessary steps mentioned above to avoid any further jeopardisation of your claim’s success. Here are some top tips to avoid some of the common pitfalls during the appeal process:

If your appeal is unsuccessful, which does happen at times, there are still two common options which policyholders can pursue, so all hope is not lost. These options are mediation and arbitration.

To begin, mediation is a more collaborative approach which involves a neutral 3rd Party who facilitates negotiations between you and your insurer to meet a mutually agreeable settlement. It’s often a quicker and less formal process than going to court, and many disputes are resolved at this stage. A mediator will listen to both sides and remain objective as they do not have any one’s side in mind. They do not make any judgements, but rather help both parties communicate more effectively whilst identifying key issues and exploring possible solutions.

Arbitration, on the other hand, is a more formal process where an arbitrator reviews the evidence and makes a binding decision for both parties. While this option may take longer, it can be a good alternative to a lengthy court case. An arbitrator's decision is final and both parties need to accept the outcome, with no appeal option.

It can be very frustrating dealing with a denied insurance claim whilst still in the aftermath of a disaster. But policyholders must remember this is not the end of the road, there are ways to appeal the decision. Ensuring a thorough understanding as to why the claim was denied is the most important phase, then successive actions can follow suit. Enlisting expert help from Harris Balcombe to take the load off and renegotiation and liaise with your insurer may be a helpful way to push the claim forward.

For more information on how Harris Balcombe can help with your insurance claim following a disaster, whether it’s domestic or commercial, Contact us today and/or start you claim .