Insurance claims denied or underpaid

After the damage, the fight over what it costs to fix

The pipe burst while you were away, or the storm took half the roof. The adjuster walked through in twenty minutes, and the estimate that followed wouldn't cover the drywall. Or the claim was denied as wear and tear, or as flooding the policy doesn't cover.

Property claims are often less about whether the insurer pays than about how much. The details below tend to decide that.

Tell us what happened

Protect the property, and document everything

Most policies require you to take reasonable steps to prevent further damage, such as covering a broken roof or stopping a leak, and they usually pay for those steps, so keep the receipts. Before anything is thrown away or repaired, photograph and video every room and every damaged item, keep samples of damaged materials if you can, and list what was lost with what you paid and roughly when.

Deadlines written into your policy

Property policies often set their own deadlines: to give notice of the loss, to submit a sworn proof of loss (a signed statement of what was damaged and what you're claiming), and to bring a lawsuit, which can be much shorter than the general rule in your state. Read the conditions section of your policy, or ask a lawyer to, as soon as you can.

Why the numbers come out low

Many underpayment disputes come down to a few terms. Actual cash value means what the damaged property was worth given its age and wear, usually less than the cost to replace it. Replacement cost means what it costs to repair or replace with something similar, though some policies pay part of it only after the work is done. Disputes also arise over matching repairs, code upgrades, and what caused the damage in the first place.

Appraisal, public adjusters and flood insurance

Many policies include an appraisal clause, a process where each side chooses an appraiser to settle a disagreement about the amount of the loss. It can help, and it can also limit what is left to argue about, so think before you invoke it. A public adjuster is a professional you can hire to prepare and negotiate the claim; they aren't lawyers and can't give legal advice. Flood damage is usually excluded from standard home policies and covered, if at all, by separate flood insurance, often through a federal program with strict rules of its own.

What helps to have ready

Your full policy, including the declarations page (the summary of your coverage) and every endorsement.
Photos and video of the damage, taken before repairs or cleanup where possible.
The insurer's estimate, and any estimates from your own contractors.
Receipts for emergency repairs, temporary housing and other costs since the loss.
Your list of damaged or lost items, with approximate age and cost.
Every letter from the insurer, including any request for a proof of loss or an examination under oath.

What to have ready before you talk to a lawyer
A short, practical list you can use for any kind of problem.

Where we fit in

A lawyer at our firm looks at your case. If we take it and another firm is better placed to lead it day to day, we choose that firm from firms we have vetted for their expertise and track record, and we stay responsible for your case with them.

Questions people ask

The insurer wants to examine me under oath. What is that?

Many policies let the insurer question you formally, with a court reporter recording your answers, before it decides a claim. You usually have to cooperate. It's serious, and a good moment to have a lawyer with you.

I already cashed a check from the insurer. Did I give up the rest of the claim?

Usually not, unless you signed something saying it was full and final, or the check or a letter with it said so. Keep a copy of anything that came with the check, and ask before you sign or cash anything further.

My business had to close after the damage. Is that covered?

It may be, if your policy includes business income coverage. These claims turn on the policy wording and your financial records, so have both ready.

Damage to your home
If a neighbor, a contractor or a utility caused the damage, there may be a claim against them too.
Credit, debt collectors and scams
If a contractor you hired to do the repairs didn't do the work or took your money.

More about insurance claims denied or underpaid

This page explains things in general terms. It is not legal advice about your situation, and the law differs from state to state.