General
Yes. Carriers can deny claims when the loss is excluded under the policy, when the cause is not covered, when the policy was not in force at the time of loss, or when the claim violates policy conditions (failure to mitigate, late notice, fraud). What you are entitled to. A denial must be in writing. The letter must cite the specific policy provision the carrier is relying on. You have the right to request a copy of the full policy and any supporting documents the adjuster used. Your options after denial. (1) Read the cited provision against your actual policy. Sometimes the cited provision applies; sometimes it applies only partially or not at all. (2) Request a re-inspection or supplemental review with new documentation. (3) File a complaint with your state Department of Insurance. (4) Engage a public adjuster (for first-party property claims) or an attorney for coverage disputes that may go to litigation. A denial is not the end. A meaningful percentage of denied claims are paid after follow-up.
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