Water Damage Claim Denied: What Should You Do?

A water damage claim denial can feel like a double blow — you're dealing with the stress and disruption of water damage, and now you're facing the additional challenge of fighting with your insurance company. Unfortunately, it's a situation many homeowners face.

This blog will explore the common reasons why water damage claims get denied, the strategies to avoid denials, and what to do when your insurance company denies your claim.

Common Reasons for Water Damage Claim Denials

Insurance companies have specific criteria for approving property damage claims.

Here's a closer look at some of the most common reasons for denial:

Excluded Perils

While homeowners insurance may cover water damage, it doesn't always cover all types of it.

The most frequent exclusions include:

Flooding

This is a significant issue in Texas, where hurricanes and heavy rains can lead to widespread flooding. Most standard homeowner's insurance policies do not cover natural disasters. You'll need a separate flood insurance policy for this coverage.

Sewer Backups

Water backing up from sewers or drains is typically excluded from standard homeowners insurance policies. However, you can often purchase additional coverage for this event.

Gradual Damage

Damage caused by slow leaks or seepage over a long period is often excluded. Insurance companies view these as issues resulting from lack of maintenance, not sudden events covered by their policies.

Lack of Proper Maintenance

Insurance companies are looking for evidence of reasonable maintenance on your property.

If your claim is denied due to lack of upkeep, you may have one of the following issues:

Leaking Roof

A leaking roof, especially if it's due to age or neglect, is often considered a preventable issue. Regular roof inspections and maintenance are essential to avoid water damage claims being denied.

Neglected Plumbing System

Ignoring signs of plumbing issues can lead to burst pipes and significant water damage. Regular plumbing inspections are crucial for preventing these incidents.

Claim Filing Delays

Promptly reporting water damage is crucial for a successful claim.

Insurance companies may deny a claim if you:

• Delayed reporting: If you delay reporting the damage, the insurer may claim it's challenging to determine the extent of the damage or the cause.
• Failed to mitigate damage: You must minimize further damage by covering damaged areas, preventing water from spreading, and taking other precautions.
• Missed the statute of limitations: The Texas statute of limitations for filing a property insurance claim is generally two years from the date of the loss.

Making sure you respond appropriately to water damage can improve your chances of receiving the compensation you deserve.

Misrepresentation or Fraud

Providing false information to the insurance company, such as by exaggerating the damage or concealing relevant details, can lead to a claim denial and potentially legal consequences.

What to Do When Your Water Damage Claim Is Denied

Receiving a denial letter is never easy, but it's important to remember you have options:

1. Understand the Denial

The denial letter should provide specific reasons for the denial. Analyze the letter to determine what the exact grounds for the claim rejection are.

2. Gather Evidence

Collect as much evidence as possible to support your claim.

This might include:

• Photographs and videos: Document the damage thoroughly.
• Repair estimates: Obtain quotes from reputable contractors for the necessary repairs.
• Maintenance records: Show your insurance company proof of regular maintenance for your property.
• Weather reports: Provide documentation of weather conditions that may have caused the damage, especially if it involves heavy rains or storms.

Organize your evidence in one location in preparation to send it to your insurance company.

3. Contact the Insurance Company

Contact your insurance company and explain your reasons for disputing the denial. Be polite but firm in your stance. It's often helpful to follow up in writing as well, sending a detailed letter outlining your arguments and the evidence you have gathered.

4. Seek Legal Assistance

If negotiations with the insurance company fail, consider seeking legal advice from an experienced attorney who can tell you if your insurance policy should have covered the damage or not. A lawyer can then guide you through the legal insurance claims process.

Tips for Avoiding Water Damage Claims Denials

Here are some legal recommendations to help protect your rights and avoid potential issues with your water damage insurance claim:

What to Do Before a Water Damage Claim

There are several steps that you can take in advance to help make the process simpler if water damage should occur on your property.

• Read your policy: Thoroughly understand your coverage, exclusions, and any specific requirements for filing a claim.
• Keep detailed records: Maintain records of all maintenance and repairs, including dates, contractors used, and receipts, as this can help demonstrate proper upkeep.
• Document potential issues: If you notice any signs of leaks, water damage, or potential problems, document them with photos, videos, and notes.

If you have concerns about potential water damage or need help interpreting your policy, consider consulting with a licensed insurance professional or a lawyer from Omar Ochoa Law Firm.

What to Do After a Water Damage Claim

Notify your insurance company immediately, even for seemingly minor issues, to start the claims process.

• Cooperate, but don't waive your rights: Work with the insurance company, but don't sign any documents or make statements that could compromise your claim.
• Document all communication: Keep copies of all correspondence, emails, phone calls, and notes from interactions with the insurance company.
• Obtain independent estimates: Get repair estimates from reputable contractors who are not affiliated with your insurance company.
• Don't settle too quickly: Consult with an attorney about insurance coverage disputes before accepting any settlement offer.

By taking proactive steps before and after a water damage event, you can greatly improve your chances of having your insurance claim approved and receiving fair compensation.

Protecting Your Rights with Omar Ochoa Law Firm

Dealing with a denied water damage insurance claim can be a frustrating experience, but remember, you have rights as a policyholder. By understanding your policy, gathering evidence, and taking appropriate action, you can increase your chances of obtaining a fair settlement.

At Omar Ochoa Law Firm, our experienced team will guide you through the claims process, providing legal advice and advocating for your best interests.

Contact us for assistance with the claims process. We’ll fight on your behalf for the compensation you rightfully deserve! Let our team be your voice, your advocate, and your partner in getting justice.‍‍‍‍