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Looking for help to dispute a Denied Insurance Claim?

denied insurance claim

A denied insurance claim can be an extremely frustrating and stressful experience, especially if you’ve experienced costly damages to your home or business. But do not lose hope just yet. Insurance Policies are complex documents and it often takes a trained eye to review the policy and to interpret how it should be applied to your specific situation.  

Even if your claim was initially denied, don’t take the insurance company’s decision as the final word. There are numerous reasons why a claim can be incorrectly denied, as we outline below. By hiring an experienced Public Adjusting Firm like Claim Concepts to fight for you, you’ll have experts on YOUR side to properly investigate, estimate and ultimately recover the full and proper settlement that your policy allows.

Here’s what you need to know.

Why was my insurance claim denied?

Insurance companies can deny claims for several reasons, but it ultimately depends on the policy and how that policy language applies to your specific claim. While every situation is unique, some common reasons why homeowner’s insurance claims are denied include: 

  • Constant or repeated seepage or leakage
  • Late Filed Claim
  • No visible damage to trigger coverage
  • Wear and Tear, Marring
  • Workmanship or Construction Defect
  • Water Damage Exclusion
  • Limited Water Damage Endorsement
  • Condensation 
  • The claim does not exceed your deductible (not an actual denial)  

Insurance policies are difficult to read and often have ambiguous language (meaning that it can be interpreted different ways).  The truth is that there is no policy that will cover any and all damage to your property (even though many TV commercials would leave you to believe otherwise) and some insurance claim denials are proper.  However, it’s important to remember many claims are improperly denied, which is why it’s so important to contact a competent Public Adjuster and have them review your policy and the insurance companies’ reason for the denial before taking their word for it. 

Reasons to contact a Public Adjuster

Insurance companies and their adjusters are required to act in good faith throughout the claims process, but that doesn’t mean they always do. The insurance company’s own adjuster is sometimes not even an employee of the company, but rather an outside contractor. Errors can occur in a number of areas, which can lead to your insurance claim being denied.

Examples of how claims can be incorrectly denied:

  • Incorrect application of the policy terms.
  • Failure to thoroughly review the policy looking for coverage
  • Engaging outcome oriented vendors 
  • Insurance Claim being Delayed

If you have found yourself in this situation and have been searching online for “public insurance adjuster,” then you’ve come to the right place. The experienced team of Public Adjusters at Claim Concepts may be able to help you resolve any of these scenarios.

How Our Public Adjusting Firm Can Help

At Claim Concepts, our Licensed Public Adjusters have decades of experience helping policyholders whose insurance claims have been denied or underpaid for numerous reasons. 

Contact us today for a free claim review and strategy session where we will be happy to go over your options. If you choose to hire us as your Public Adjusting Firm, we will thoroughly evaluate your policy, document and accurately estimate your losses and communicate with the insurance company as needed to get you the maximum settlement allowed under your policy.

Don’t settle for a denied claim – you still have options! Call 800-801-2099 to speak with a licensed Claim Concept Public Adjuster today about your claim.

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Meet Our Leadership Team at Claim Concepts

Our Commitment

At Claim Concepts, Eric and Greg embody the epitome of professional excellence, seamlessly intertwined with a profound personal commitment and a fiery passion that sets them apart. Their unique journeys reflect our company’s commitment to defining, genuinely understanding, and advocating for our clients. With Claim Concepts, you’re hiring experts and gaining partners who will tirelessly ensure your rights and interests are protected and fairly served.

Greg Roover

Greg Roover - Owner and Public Adjuster at Claim Concepts: Leading the Way in Insurance Claims Assistance
Owner/Public Adjuster

Inspired by Personal Experience

Greg’s path to becoming a Public Adjuster was deeply personal. The Northridge Earthquake was a turning point, where his family’s experience with a public adjuster opened his eyes to the profound impact of this role. Greg embarked on a strategic career journey, motivated by a desire to help others as his family was helped. He honed his skills working for prominent insurance companies as an independent insurance adjuster and NFIP-certified flood adjuster. 

In 2008, Greg’s vision came to fruition with the founding of Claim Concepts. His insider knowledge, gained from years within the industry, and his passion for aiding others have been instrumental in the company’s success. Greg’s expertise is not just in his impressive resume but in the countless testimonials from those he has aided, reflecting his dedication to securing the rightful settlements for our clients.

Greg's Expertise Backed by Industry Accreditations

Morgan "Eric" Thomas

Morgan - Your Trusted Public Adjuster at Claim Concepts
Public Adjuster

From Adjuster to Advocate

Eric’s journey in the insurance world began in 1989, marking the start of a career defined by expertise and dedication. Fresh out of college, he jumped into the role of an independent adjuster, swiftly advancing to a general adjuster position at a major firm. There, Eric specialized in complex homeowners and commercial property insurance claims, showcasing his skill in navigating intricate scenarios. 

In 2001, his career took a pivotal turn towards the construction aspect of insurance. As the General Manager for a renowned Insurance Restoration Contractor, Eric oversaw everything from estimating to maintaining vital relationships with insurance companies. His profound understanding of insurance and construction led him to Claim Concepts, where he now thrives as a Public Adjuster. His unparalleled insight has been crucial in ensuring that our clients receive the settlements they genuinely deserve

Eric's Expertise Backed by Industry Accreditations

Begin Your Hassle-Free Damage Claim Journey Today with Our Expert Support

4 EASY STEPS TO FILE A DAMAGE CLAIM WITH US

Our team of experienced insurance professionals has developed a proactive claim management strategy & process to help you receive the proper settlement that you need and deserve. We understand that proving your claim can be a daunting and time-consuming, and we are here to alleviate that burden for you. Our goal is to make this process as seamless and stress-free as possible for you while ensuring that you recover the full and proper settlement for your loss.

STEP 1 - Complimentary Consultation

We invite you to speak with one of our professional Public Insurance Adjusters about your situation. Our team will carefully review your policy, claim-related documents, and the extent of your damages. Based on our thorough evaluation, we will then offer our professional opinion on the best course of action for your specific circumstances.

STEP 2 - We Go To Work On Your Behalf

Our team of experienced public adjusters is dedicated to thoroughly documenting every aspect of your claim. We understand the importance of utilizing advanced technologies, such as 360 photography, thermal imaging, and moisture detection equipment, to fully capture all damages. This meticulous process ensures that we have a comprehensive record of all losses incurred. We will then prepare a detailed estimate, utilizing industry-standard estimating software, and assist you in creating an inventory of damaged personal property.

STEP 3 - Path Toward Settlement

Upon your approval, we will submit the estimate along with any supporting documentation to the insurance company on your behalf.  We will always protect your interests and ensure that you comply with all of your post-loss obligations provided within the policy.

STEP 4 - Settlement

We will keep you in the loop and present any offers made by the insurance company.  We will only accept settlement offers with your approval. 

GOT QUESTIONS? WE HAVE ANSWERS

Peace of mind! We are here to represent you and your interest in the claim. Unfortunately, insurance companies often times deny claims that should be paid or do not pay enough money on a covered claim. This is not always the case and even when it is it may not be intentional. I know that most adjusters have the best of intentions but sometimes they may be inexperienced or simply trained to see things one way, the way the big insurance company wants it to be seen. As Public Adjusters our number one job is to get you the largest settlement available to you under your policy with the insurance company.

NO. By state law we as Public Adjusters are not allowed to represent the insurance companies. We can only represent the insuring public.

The public adjuster is employed by you, the insured. Their function is to represent your interests and ensure that you recover the proper settlement for all of your losses per the terms of your insurance policy. The insurance company’s adjuster works for the insurance company and is responsible to protect their interests throughout the claim.

Public Adjusters typically work on a contingency basis which equals a small percentage of any money recovered by the insurance company.

NO! This is NOT required under any policy that I have seen to date and I do not recommend it.  In the event of a loss it is best to employ a Reputable Public Adjuster that knows what the policy will cover and what it takes to get your property back to its pre-loss condition. Many contractors will provide you with a competitive bid to make repairs but not necessarily get your property back to its pre-loss condition.

No.   In most cases we can reopen your file with a supplemental claim. There are many factors involved. Give us a call and we will be happy to offer you a free claim consultation.

Not necessarily.  It is not recommended to file a claim every time you spill a glass of water as you may become classified as a nuisance claim maker. Property insurance is typically rated based on your area which is why all homeowner rates increased in Florida after the hurricanes, whether you filed a claim or not. The risk is more related to the area where your property is located and in commercial situations the use of the property.  However, it is known that there are databases where claim activity is logged and each insurance company may have their own stipulations based on claim activity of the individual or the property.  Ultimately, you buy insurance to protect you in the time of a loss.  If you are debating whether you should file a claim or not, please feel free to call and speak with one of our Public Adjusters about your particular situation, we are always happy to help.

Do not do anything before having a qualified Public Adjuster or Attorney take a look at your file. Depending on the way everything is written you may be agreeing to their offer by depositing the check. We do not charge anything to come out and evaluate your particular situation.