Property Insurance: Improper Claim Filing Can Result In Denied Claims

Homeowners Policies are the “norm” in the insurance world for Home Condo / Co-Op / Apartment property. This post looks at the aspect of Property Claims only. The liability portion will be dealt with elsewhere.

If your home (Condo/Co-Op/Apartment) is damaged by a natural disaster, a fire or a long-term effect like mold growth, you would naturally file a claim with your homeowner’s insurance company.

But what if you don’t contact the company right away? Would the insurer still pay if you filed a claim six months after an event?

While policies vary, they generally state that if you do not report your claim in a timely manner, it may be denied. Some insurers may have a limit of just 30 days to file a claim, but others allow up to a year after an incident.

Many insurance policies may not include an exact time frame, but instead require you to provide “prompt” or “immediate” written notice to your insurance company or agent if you suffer a loss.

The amount of time you have to file will be stated in your policy language. If you aren’t sure where that part of your policy is, feel free to contact us. It’s important that you read the policy and understand your responsibilities when filing a claim.

Whatever you do, it’s best to file your claim immediately after you know something happened.

If you have special circumstances you can ask the insurance company for an extension, such as after a major catastrophe when you haven’t been able to reach your home to assess the damage. In addition, insurance companies may see their own resources stretched during catastrophes, so they may ask you for more time to adjust the claim.

The reason for the prompt notification requirement is that the original damage can be made worse by the elements or other issues if left unattended after the initial damage.

The closer the time between the event and when you file the claim, the easier it is to prove the damage was the result of this covered event and not caused by some secondary issue that does not fall under the scope of coverage.

The insurer can claim you were negligent in not filing the claim in a timely manner, which resulted in the initial damage increasing due to exposure to the elements and other issues.

If it is found that the the damage to your home could have be been prevented by filing a claim more quickly, you may be held financially responsible for the repairs.

The slow drip or unseen damage

Sometimes you may be unaware of damage because it takes a long time to develop or you don’t see the damage (like a hole in your roof that was caused by a falling tree limb during a storm).

In instances like this the insurance company could deny your claim, saying the damage to your floor was caused by you not fixing the initial damage.

One of the most common types of claims that may be delayed is water-damage claims. In these instances, a sudden event that causes damage is usually covered, but not one that has caused damage over time.

Types of water damage many policies cover:

  • Sudden or accidental discharge
  • Sewer back-up or water back-up [CAUTION: POLICIES VARY GREATLY ON THIS ONE! READ YOUR POLICY]
  • Overflow
  • Storm-related water damage

Gradual-damage claims that could likely be denied include holes in the roof due to neglect in replacing broken shingles, and long-standing pipe leaks that damage your walls and floor.

SUMMARY: Report claims as soon as you know that something may be wrong. Don’t let ‘late reporting’ lead to disappointment for an item that would otherwise have been covered.