Top Reasons a Homeowners Insurance Claim Gets Denied

Sometimes, a homeowners insurance claim gets denied. The reasons behind a denial can vary significantly. 

It may simply be an error on the part of the insurance company or even a bad-faith attempt to avoid paying out. More often, however, a claim being denied is the result of an issue with the claim. A policy might not cover the damage, or the policyholder may have made a misstep in the claims process. 

In 2021, 5.3% of insured homes had a claim, so it’s important for homeowners to learn how their policies work and how to best reduce their risk of a claim denial.[1] Claims are frequently for thousands of dollars in damage, with the average severity of damage hovering around $15,000 or more depending on the year. Failing to get that damage covered could be catastrophic for a household, especially if a policy should theoretically have covered it.

8 Reasons Your Home Insurance Claim May Be Denied

There are a variety of reasons why a home insurance claim may be denied. It’s important to fully understand your insurance policy when submitting a claim, and it’s even more important if your claim has been denied but you believe the claim was valid under your policy. 

These are some of the most common reasons for denial of a homeowners insurance claim in 2023:

1. Your Policy Doesn’t Cover the Damage

An insurance claim is only going to cover damage of the kinds listed in the policy. A few items are standard when it comes to coverage, such as fire damage and some (although not all) types of damage resulting from natural disasters, such as lightning.[2] 

You should always read the specifics of your own policy when trying to determine what may or may not be covered. However, some types of damage that aren’t standard include the following:

• Earthquake damage
• Flooding damage
• Vandalism
• Wildfires

Additionally, policies do not generally cover damage that a homeowner deliberately causes.

You can read more about what isn’t covered in a homeowners insurance policy here.

2. You Didn’t Take Action to Reduce Damages

Homeowners insurance typically won’t cover damage that you made no effort, or improper effort, to reduce. For example, if a toilet is leaking, it is expected that you don’t simply allow it to leak indefinitely, damaging your floor. Instead, you must attempt to turn off your water in a relatively timely manner and take at least some action to dry the water that has leaked if possible. 

This doesn’t mean you need to imperil yourself or others to successfully submit a claim. If your home is on fire, it isn’t expected that you attempt to put out the flame when it would be unsafe to do so. However, it would be expected that you made an active effort to contact emergency services, so the fire department is made aware of the fire. 

The standard is that you must take basic preventative action to prevent a given issue from getting unreasonably worse over time.

3. Your Claim Is Missing Information

If a submitted claim is missing information required under your policy, the claim is likely to be denied. It is also likely to be denied if the information submitted is inaccurate or willfully misleading. Submitting a claim with these types of inaccuracies could open you up to legal action. 

When submitting a claim, read your policy to see which information you are responsible for submitting. If something is unclear, contact your insurance provider and ask what they need for you to submit a claim. 

Do not attempt to misrepresent the truth to get a greater payout. This would likely be considered fraud and could make what is likely already a difficult situation for you even worse.

4. Your Claim Was Filed After the Coverage Date Passed

Your insurance contract will generally indicate a specific period of time under which your home is protected by your insurance. This highlights why it is important that you submit an insurance claim as soon as possible. 

If you delay submitting your claim, it increases the chance you miss an important deadline regarding your coverage date. If your coverage date has passed, your claim will be denied.

5. The Claim Is Related to General Wear & Tear or Neglect

Homeowners insurance does not cover wear and tear nor willful neglect. Wear and tear is a term that refers to damage that occurs to parts of a home over time as part of normal use. 

For example, a garage door’s wheels will slowly wear down, much like a car’s tires will, with repeated opening and closing. If the door one day breaks due to this wear, that damage is unlikely to be covered by your insurance.

Damage resulting from neglect is damage caused by failing to take basic precautions to prevent damage. For example, imagine a heavy wind blowing several tiles off your roof. If you fail to get your roof repaired, allowing rain to seep through the resulting hole and cause water damage, that damage may not be covered. 

You are expected to have made some effort to stop an obvious point of weakness in your home. If you didn’t make that effort and water caused damage as a result, it will likely not be covered by your policy. 

6. You Are Behind on Your Premium Payments

Your insurance is only likely to cover damage if you’ve been paying your balance. If you fail to make payments, eventually, your coverage will lapse, and you will no longer have coverage.

Former claims specialist Koosis says, “Remember, this cancellation will likely be retroactive, so even if you’ve already submitted a claim, you may get denied if you failed to make payments and your insurance is canceled retroactively.”

This is why it’s important to pay your monthly premiums on time.

7. The Insurance Company Suspects Fraud or Lying

If an insurance company suspects you have misled them, they will deny your claim. They may also take legal action against you.

To avoid false accusations of fraud and similar issues, document everything you can about the damage that occurred, and make sure you submit your claim in a timely way. The more provable specifics you can provide about any damage that has occurred, the better. 

Take photographs and videos of any damage, as well as of any measures in place to help reduce that damage. Get documentation about the incident if you can, such as police reports for any crimes that occurred or invoices from professionals you paid to mitigate damage. 

Part of why contacting your insurer promptly is important is because they will likely send an insurance adjuster to inspect the damage. This is a professional whose job is to look at the damage that has occurred and determine how much an insurer should pay. The sooner this professional can inspect the damage, the less likely they are to suspect the scene has been tampered with and the less likely it is that details might deteriorate on their own, such as through rot or wind damage. 

8. You Missed the Claim Filing Deadline

An insurance claim must typically be filed within a certain time period of the damage occurring. This claim window can be anywhere from a month to a year, sometimes even longer, and will depend on the specifics of your policy.[3] 

Take note of filing deadlines and make sure you file before that point. If you miss the deadline, your claim is likely to be denied. However, the claim-filing deadline typically doesn’t apply to appeals.

What to Do if Your Home Insurance Claim Is Denied

Your homeowners insurance policy will generally outline the appeal process by which you can dispute a denial of your claim. Adequate documentation regarding the damage is essential during this process, so make sure to gather photo evidence, contractor quotes, and relevant proof of damage for your appeal. 

It is often wise to speak with an attorney, especially if the situation is complicated or a significant amount of money is on the line. An attorney can help to maximize your chances of success. 

You can read more about how to appeal a denied homeowners insurance claim here.

Frequently Asked Questions About Homeowners Insurance Claim Denials

We’ve compiled some of the most frequently asked questions regarding why homeowners insurance claims might get denied here.

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Reviewed by Lisa A. Koosis

Lisa A. Koosis is an experienced content writer who has ghostwritten extensively for clients in the insurance and finance sectors. As a subject matter expert, she can explain complex financial topics in easy-to-understand language. Lisa is well-versed in topics ranging from life insurance to pet plans and specializes in medical insurance including Medicare, Medicaid, and commercial plans.