7 Main Reasons Why Insurance Claims Are Denied

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Insurance claim form rejected

Insurance claim form rejectedInsurance Claim Denied | If your home insurance claim has been denied or rejected, you probably learned about it from a letter you received from the insurance adjuster assigned to the claim.

The letter should have explained the reason why your claim was denied, and referenced the portion of your policy that supports the company’s decision.

If the letter did not fully explain why your home insurance claim was denied, you need to call your insurers and clarify the reason with your loss adjuster.

The main reasons why insurance claims are denied

Below are the seven main reasons why insurance claims are usually denied:

1. Non disclosure of material fact
If you take a new policy without informing your new insurer of previous claims and facts with previous insures they can repudiate your claim based on non disclosure of material fact- Always disclose your claims history as it changes your underwriting criteria and different loadings will be applied.

2. Policy Exclusions– Wear and Tear, Gradual deterioration, breakdown in materials, lack of maintenance etc. are usually grounds for a claim not being covered. (however if your pipes leak due to wear and tear your insurance company will still cover the resultant water damage).

3. Changes in policy risk during insurance period
If you for some reason during the course of a policy your risk increases insurers will need to be informed and they may increase premium . the most common risk increase in domestic homes is sub letting or renting of property. These must be disclosed to insurers mid policy.

4. Un-occupancy or Un-attended property

If your property is un occupied for periods over 30-60 (depending on policy)days certain aspects of policy cover may be removed and reduced as the risk of damage is increased with un-occupancy. If you are leaving your property unattended for a lengthy period inform insurers and they will advise on precautions to comply with policy conditions.

5. Non insurable interest

You can only insure property you have an interest in. i.e. if a work owned laptop is stolen from your home your insurer will not cover this item. Your employer is the party with the insurable interest and is legally responsible for insuring this item.

6. Failure to pay insurance premium or direct debit is declined

Unfortunately if you fail to pay your insurance premium or your direct debit is declined, your insurance lapses. Always make sure that you have sufficient funds in your account to cover the premium, it is not worth the risk of having your insurance claim rejected.

7. Late Notification

If you suffer a loss you need to inform your insurance company as soon as possible. Some insurers allow up to 30 days to report a claim. Not reporting a claim in good time may lead to your claim be refused.


Insurance Claim Denied? We may be able to help…

There are cases where the reason for a denied homeowners insurance claim are clear, however, there are those times where the decision is not so black and white. Keep in mind that if the insurance company finds a grey area, they will typically favour denying the claim and saving money!

Taking action to dispute a home insurance claim that has been denied can be difficult, but if you have a valid reason, it is worth fighting for your rights. Give Insurance Claim Solutions a call, we may be able to help.


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Insurance Claim Solutions is a registered and regulated insurance claim loss assessor. If you have suffered a financial loss – then contact us today to ensure you receive the best possible financial outcome.