Is it Possible Your Homeowners Claim Could Be Denied?

The simple answer is yes, it could be, but the answer isn’t always so simple.  A claims adjuster’s job is to find coverage under your homeowners policy to cover your loss. There are however, scenarios that make it more certain that your claim will be denied. As your agent, it is not an easy task telling a homeowner their loss is not covered.

homewoners claim in york paEvery claim is handled individually, and is fact specific. Triggering coverage under the homeowners policy is based on the specific details leading up to the loss and the insurance contract.  Homeowners that experience claims could potentially have their loss partially or completely denied depending on the facts leading to the loss.

I’m sure you’re asking yourself, “could this happen to me”?  Let me give you an example of a homeowner’s claim that may be denied coverage. Let’s say your home has an old roof with some damaged shingles and the roof has outlived its life expectancy.  The roof is no longer doing the job it was intended to do of protecting your home. You have been planning to get that roof replaced but you just never got around to it.  Life happens, as we all know. A storm occurs. You suffer damage to your roof, and as a result to the interior of your home from water leaking in down the wall.  At this point, you are feeling confident it will be covered by your policy.

You call your insurance company to report the claim.  They send an insurance adjuster to come out to investigate what happened. The adjuster discovers the roof was in poor condition because the roof was neglected and is no longer doing the job it was intended to do. So, your claim more than likely will be denied. At this point, you aren’t happy about the result. As most policy holders do, they assume the insurance company will fix anything, “What do I have insurance for?”

As a homeowner you are responsible for keeping your home in good condition.  An insurance policy is not intended to be a maintenance policy.  Updating the roof once it reaches its life expectancy or shows signs of damage, servicing the mechanicals including heating, plumbing, and electrical are a few areas that could prevent a claim from occurring. The likelihood of your claim being denied then becomes much less. Your policy is intended to cover sudden and accidental occurrences, not materials that are deteriorating.  It’s always a good practice to keep your home updated. In doing so, you will lessen the chances of your claim being denied.


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