Top Reasons Why a House Fire Insurance Claim May be Denied

If you are the owner of a fire-damaged house, you may be concerned about whether the claim you file with your insurance company is going to be denied.

Claims are denied more often than many homeowners realize. Here are the main reasons house fire insurance claims are denied as well as what you can do to help ensure your claim is accepted.

Common Reasons House Fire Insurance Claims Are Denied

Reason #1 – Unpermitted Work

This is one of the most common reasons a house fire insurance claim is denied. Basically, what happens here is that a fire occurs while work is being done on your home – and those performing that work don’t have the correct permits. To avoid this reason for denial, be sure to have all home repair work done by a licensed professional who is willing to stay in compliance with your city or county building codes.

Reason #2 – Possible Fraud Alleged  

If there is a prior history of fire loss or you have large debt that could be forcing you into bankruptcy, there is a good chance your house fire insurance claim could be denied.

Other reasons a house fire insurance claim could be denied for possible fraud include a recent increase in coverage before the fire and a provided value of belongings that doesn’t match up with your income.

In many cases were possible fraud is alleged, an investigator may call for a fire investigation before a claim is approved or denied.

Reason #3 – House is Vacant at Time of Fire

If the house has been vacant for more than 30 days and there were no signs of renovation occurring at the address, the house fire insurance claim may be denied.

Something else that could happen here is that you receive only a payout for the value of the building itself. This type of payout could make it difficult, or nearly impossible, to rebuild your home to the state that it was in before the fire.

Additional Tips to Prevent Your House Fire Insurance Claim from Being Denied:

Tip #1 – Contact Your Insurance Company Quickly!

First, one requirement of all insurance policies is that the policyholder must promptly notify the company in the event of a fire so that its representatives can inspect all damaged property.

Delaying and not contacting your insurance company in a reasonable amount of time could lead to your claim being denied.

So as soon as possible after your fire, contact your insurance agent. When speaking with your agent either on the phone or in person you should also request a certified copy of your insurance policy.

Tip #2 – Keep Track of Everything During the Claims Process

The claims process, particularly after a house fire, is certainly not quick and easy. One of the best things you can do to keep the process moving along smoothly is to stay as organized as possible.

Keep copies of all receipts, bills and contracts! You should also document all living expenses and any matters that come up regarding your house fire or the claims process.

Then keep all this information in one easy-to-access place. Don’t trust your insurance agent to take care of things for you or to keep track of all the paperwork. You need to do it!

Having the right information on hand and easy to access can help prevent your house fire insurance claim from being denied due to incorrect information or because something – like a proof of loss – wasn’t filed on time.

Tip #3 – About That Proof of Loss – If One is Requested, Be Sure to Submit it!

One of your duties following a house fire may be to submit what is called a Proof of Loss. Check your policy’s Conditions Section to find out if you need to do this.

If this is listed in your Conditions, you need to submit it promptly. Here are some things to keep in mind:

 

  • Not all adjusters require a proof of loss but if they do it is a very important document
  • Proof of Loss is a form but if you prefer you can submit a written notarized statement
  • Be sure to include all claim documentation that a Proof of Loss requires
  • Make sure you understand the time limit for Proof of Loss submission as set forth in your insurance policy. Missing the deadline could have catastrophic effects, including an outright loss of coverage
  • If you are going to have trouble meeting the deadline, immediately ask for an extension in writing

 

Tip #4 – Be Sure You Understand Your Insurance Policy

You should be familiar with all of the following:

Declarations Page – One-page summary that identifies the property being insured and the policy period. It also lists the amount of the insurance, deductibles, endorsements and the home owners’ names.

Insuring Agreement – This short, simple paragraph explains that the property is covered by insurance if the premiums are paid and all policy provisions are complied with.

Damaged Items – This section details items covered by the policy. The key thing to keep in mind here is do not dispose of any damaged items until the claims adjuster has reviewed them and OK’d their removal. Getting rid of items before an inspection could result in you not being reimbursed for them.

Exclusions – This section sets forth a number of instances where property loss will not be covered under the policy. Examples may include intentional loss, flooding, governmental action or earth movement.

Coverages – This section describes the property covered and lists any limits or restrictions for certain classes or locations of property. Also, depending on the type of policy you purchased, this section may set forth that your property is covered on a “specified perils” or “all risk” basis. Peril refers to a direct cause of loss, such as a fire, a tornado, lightning, theft, vandalism, a wildfire, an explosion and more. Most policies only list exclusions from coverage, such as flooding and earthquakes.

Definitions – Here you’ll find definitions for common policy terms, including “you,” “your” and “business.”

Want to Sell Your Home After a House Fire?

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