Denied Claims
Your claim was denied. That is not the end of it.
350 denial reasons explained. Find yours below — most are negotiable, many are improper.
350 pages in this collection
Pre-Existing & Causation Disputes
19The most common denial pattern: "this damage was already here" or "wear-and-tear, not a covered peril."
- Anti-Concurrent Causation Clause. Denied Claim Guide.Policy language excludes any loss involving excluded perils, even partially.
- Concurrent Causation. Denied Claim Guide.Multiple causes contributed; carrier selects the excluded one as proximate.
- Continuous Flood Event. Denied Claim Guide.Carrier treats water damage as continuous flood rather than sudden storm event.
- Continuous Wind Event. Denied Claim Guide.Carrier groups multiple wind events into one for deductible application.
- Faulty Prior Workmanship. Denied Claim Guide.Carrier claims prior workmanship caused loss.
- Gradual Damage. Denied Claim Guide.Carrier claims the damage occurred over time, not suddenly.
- Gradual Water Seepage Exclusion. Denied Claim Guide.Carrier classifies water damage as slow seepage (excluded) rather than sudden discharge.
- Mold Caused by Gradual Water (Excluded). Denied Claim Guide.Carrier denies mold remediation because underlying water was gradual.
- Mold Classified as Pre-Existing. Denied Claim Guide.Carrier claims mold pre-dated water event.
- Normal Wear, Neglect, or Lack of Maintenance. Denied Claim Guide.Carrier claims damage is from lack of maintenance, not covered peril.
- Peril Misclassified by Carrier. Denied Claim Guide.Carrier classifies covered peril as excluded.
- Pre-Existing Damage. Denied Claim Guide.Carrier claims damage existed before the policy period or loss event.
- Pre-Existing Environmental Hazards. Denied Claim Guide.Carrier claims asbestos, lead paint, or mold existed before loss.
- Pre-Existing Foundation Damage. Denied Claim Guide.Carrier claims foundation damage predated sinkhole activity.
- Prior Settlement Precludes This Claim. Denied Claim Guide.Carrier alleges prior settlement extinguishes current claim.
- Roof Damage Denied as Pre-Existing. Denied Claim Guide.Carrier claims storm damage was actually prior wear.
- Sudden Event Classification Dispute. Denied Claim Guide.Carrier classifies event as gradual (excluded) rather than sudden.
- Undocumented Prior Loss. Denied Claim Guide.Carrier alleges undisclosed prior loss affected this claim.
- Wear and Tear. Denied Claim Guide.The most commonly overapplied denial. Carrier claims your damage was pre-existing wear.
Coverage Exclusions
27When the carrier points to specific policy language to deny coverage entirely.
- Air Conditioner Condensation Excluded. Denied Claim Guide.Carrier classifies HVAC condensate damage as maintenance.
- Basement Water Intrusion Excluded. Denied Claim Guide.Below-grade water damage excluded.
- Carpet Pile Height Mismatch. Denied Claim Guide.Partial carpet replacement with pile height difference.
- Construction Defect Exclusion. Denied Claim Guide.Carrier attributes damage to original construction defects, which are excluded.
- Cosmetic Metal Roof Damage. Denied Claim Guide.Metal roof hail denting classified as cosmetic.
- Earth Movement Exclusion. Denied Claim Guide.Carrier claims damage is from earth movement (not sinkhole activity), which is typically excluded.
- Environmental Hazards Exclusion. Denied Claim Guide.Asbestos, lead paint, or PCB discovery triggers exclusion.
- Flood Exclusion Applied. Denied Claim Guide.Carrier classifies damage as flood, which is excluded under homeowners.
- Food Spoilage Outside Event Coverage. Denied Claim Guide.Food spoilage during power outage not covered.
- Heat Wave / Humidity Exclusion. Denied Claim Guide.Damage from extreme heat or humidity excluded.
- Insect Infestation Damage. Denied Claim Guide.Termite or carpenter ant damage excluded.
- Intentional Acts Exclusion. Denied Claim Guide.Carrier claims damage was caused intentionally.
- Manufacturer Defect Exclusion. Denied Claim Guide.Carrier claims the failure was a manufacturing defect, not a covered peril.
- Mold Exclusion on Basic Policy. Denied Claim Guide.Basic policy excludes mold entirely.
- Mystery Disappearance Exclusion. Denied Claim Guide.Carrier classifies theft as mysterious disappearance to invoke exclusion.
- Pet-Related Damage. Denied Claim Guide.Damage caused by domestic animal excluded.
- Pollution Exclusion. Denied Claim Guide.Carrier applies pollution exclusion to remediation costs.
- Power Surge Exclusion. Denied Claim Guide.Carrier claims electronics damage from power surge is excluded.
- Recycling or Destruction Exclusion. Denied Claim Guide.Loss from recycling or destruction equipment excluded.
- Rodent Damage to Personal Property. Denied Claim Guide.Rodent damage to contents typically excluded.
- Rodent or Vermin Damage. Denied Claim Guide.Carrier claims damage is from rodents/vermin, which is typically excluded.
- Roof Age Exclusion. Denied Claim Guide.Carrier denies because roof is older than policy's age cutoff.
- Tenant-Occupied Exclusion. Denied Claim Guide.Policy excludes losses when property is tenant-occupied.
- Trailer Damage Excluded. Denied Claim Guide.Utility trailers excluded from coverage.
- Vacant Property Exclusion. Denied Claim Guide.Carrier claims property was vacant beyond policy-allowed window at time of loss.
- Voluntary Parting of Property. Denied Claim Guide.Carrier alleges insured voluntarily gave up property.
- Wildfire Coverage Limited. Denied Claim Guide.Florida policies may have specific wildfire provisions.
Roof & Matching Denials
22Roof age, partial roof denials, cosmetic-only carve-outs, and "matching" disputes for siding, tile, brick, and finishes.
- Brick Matching Denied. Denied Claim Guide.Partial brick replacement with visible difference.
- Cabinet Door Matching Denied. Denied Claim Guide.Kitchen cabinet partial replacement with visible aesthetic difference.
- Cabinet Matching Denied. Denied Claim Guide.Carrier authorizes partial cabinet replacement without matching.
- Cosmetic Damage Only. Denied Claim Guide.Carrier claims damage is cosmetic and excluded under cosmetic damage endorsement.
- Cosmetic-Only Roof Damage. Denied Claim Guide.Carrier classifies hail or wind roof damage as purely cosmetic.
- Countertop Seam Matching Denied. Denied Claim Guide.Partial countertop replacement creates visible seams.
- Denied Because Damage Is Wind, Not Hail. Denied Claim Guide.Carrier accepts cause but disputes specific peril.
- Door Series Matching Denied. Denied Claim Guide.Partial door replacement with visible difference.
- Drywall Texture Mismatch Denied. Denied Claim Guide.Partial drywall repair with texture mismatch.
- Fence Replacement Style Downgrade. Denied Claim Guide.Carrier approves lower-grade fence than original.
- Floor Tile Matching Denied. Denied Claim Guide.Partial tile replacement with different lot.
- Flooring Matching Denied. Denied Claim Guide.Carrier refuses full flooring replacement despite matching issues.
- Insufficient Proof of Damage Cause. Denied Claim Guide.Carrier requires more evidence of covered cause.
- No Proof of Mitigation. Denied Claim Guide.Carrier denies portions of claim citing insufficient mitigation documentation.
- No Written Proof of Loss. Denied Claim Guide.Carrier rejects claim absent a sworn proof of loss.
- Partial Roof Repair Denied (No Matching). Denied Claim Guide.Carrier authorizes partial repair that cannot match existing roof.
- Pre-Storm Roof Condition. Denied Claim Guide.Carrier attributes damage to pre-storm condition.
- Proof of Loss Incomplete. Denied Claim Guide.Carrier claims the sworn proof of loss was deficient.
- Proof of Loss Time Bar. Denied Claim Guide.Carrier alleges POL filed beyond policy window.
- Roof Membrane Puncture Denied. Denied Claim Guide.Carrier attributes flat roof puncture to foot traffic.
- Siding Matching Denied. Denied Claim Guide.Carrier approves partial siding replacement not matching existing.
- Window Brand Mismatch Denied. Denied Claim Guide.Partial window replacement with different brand.
Procedural, Timing & Documentation
21Late notice, missed deadlines, examinations under oath, sworn proof of loss, and documentation defects.
- Agreed Scope Signed Under Pressure. Denied Claim Guide.Agreed scope was signed but insured now disputes.
- Appraisal Invoked Untimely. Denied Claim Guide.Carrier claims appraisal invocation was too late.
- Claim Package Incomplete. Denied Claim Guide.Carrier claims submitted package missing required items.
- Conditions Precedent Not Met. Denied Claim Guide.Carrier claims a specific policy condition was not satisfied.
- Delayed Mold Discovery. Denied Claim Guide.Carrier denies mold coverage citing late discovery.
- Examination Under Oath Refused. Denied Claim Guide.Carrier claims insured refused to sit for EUO.
- Failure to Preserve Evidence. Denied Claim Guide.Carrier claims you destroyed evidence critical to assessing cause.
- Inadequate Discovery Response. Denied Claim Guide.Carrier alleges discovery responses were incomplete.
- Inadequate Evidence Before Demolition. Denied Claim Guide.Carrier denies based on insufficient pre-demolition documentation.
- Inadequate Initial Scope. Denied Claim Guide.Initial scope sheet excluded obvious damage.
- Inadequate Inspection. Denied Claim Guide.Carrier's inspection was cursory; missed substantial scope.
- Inspection Refused by Carrier. Denied Claim Guide.Carrier refuses re-inspection after scope dispute.
- Late Invocation of Appraisal. Denied Claim Guide.Carrier argues insured waited too long to invoke appraisal.
- Late Notice of Claim. Denied Claim Guide.Carrier claims you reported the loss outside the policy notice window.
- Missed Notice Deadline. Denied Claim Guide.Carrier claims you filed too late.
- Missing Contractor Authorization. Denied Claim Guide.Work done without specific contractor authorization.
- No Police Report on File. Denied Claim Guide.Carrier denies theft claim because no police report was filed.
- Notice Not in Writing. Denied Claim Guide.Carrier alleges verbal notice insufficient.
- Partial Reporting Requirement. Denied Claim Guide.Carrier claims partial loss triggered specific reporting obligations.
- Statute of Limitations Exceeded. Denied Claim Guide.Carrier alleges legal deadline passed before claim.
- Tornado Insufficient Evidence. Denied Claim Guide.Carrier denies tornado classification affecting scope.
Misrepresentation & Fraud Allegations
9When the carrier alleges the application, the claim, or the loss itself is misrepresented or fraudulent.
- Arson Suspicion. Denied Claim Guide.Carrier investigates or denies claiming intentional fire.
- Claim Voided for Fraud Investigation. Denied Claim Guide.Carrier invokes SIU investigation.
- Fraud or Material Misrepresentation. Denied Claim Guide.Carrier claims you misrepresented facts on application or during the claim.
- Fraud Referral Suspicions. Denied Claim Guide.Carrier refers claim to special investigation unit.
- Inconsistent Damage Stories. Denied Claim Guide.Carrier alleges inconsistent descriptions of damage.
- Material Misrepresentation. Denied Claim Guide.Carrier claims you misrepresented facts on application or renewal.
- Materially False Statements. Denied Claim Guide.Carrier alleges material false statements in claim.
- Undisclosed Renovations. Denied Claim Guide.Carrier claims material renovations were not disclosed.
- Undisclosed Vacancy. Denied Claim Guide.Carrier claims the home was vacant beyond policy limit.
Settlement Math, Sublimits & Caps
151Depreciation, ACV/RCV math, hurricane deductibles, sublimits, and lowballed scope of repair.
- Additional Structure Not Listed. Denied Claim Guide.Carrier refuses coverage for unlisted accessory structure.
- Adjuster Lowballed the Estimate. Denied Claim Guide.Carrier adjuster's scope materially undervalues the loss.
- AOB Solicitation Post-Storm. Denied Claim Guide.A contractor solicited an AOB in the days after a declared disaster.
- Appliance Damage Not Covered Beyond Incidental. Denied Claim Guide.Carrier limits appliance damage to specific sublimit.
- Appliance Surge Damage Not Covered. Denied Claim Guide.Carrier excludes electronic surge damage.
- Arbitration vs Appraisal Conflict. Denied Claim Guide.Carrier pushes arbitration when appraisal was invoked.
- Bad Faith Allegation By Insurer. Denied Claim Guide.Carrier alleges insured acted in bad faith.
- Business Activity on Premises. Denied Claim Guide.Carrier claims business use on residential property voids coverage.
- Carrier Delays Inspection After Storm. Denied Claim Guide.Carrier inspection delayed beyond statutory windows.
- Carrier Demands Complete Financial Records. Denied Claim Guide.Carrier requests extensive financial documentation.
- Carrier Denied Partial Claim. Denied Claim Guide.Carrier refuses to process parts of claim.
- Carrier Pressures for Recorded Statement. Denied Claim Guide.Carrier demands a recorded statement before documentation is complete.
- Carrier Requested Death Certificate. Denied Claim Guide.Carrier requesting death certificates for inherited property claim.
- CAT Team Lowballed the Claim. Denied Claim Guide.Catastrophe team adjuster produced a minimal scope of loss.
- Claim Assignment Disputed. Denied Claim Guide.Carrier disputes assignment of claim rights.
- Claim Attributed to Non-Hurricane Wind. Denied Claim Guide.Carrier classifies loss as non-hurricane wind to avoid deductible structure.
- Claim Investigation Exceeded 15 Business Days. Denied Claim Guide.Policyholder asserts carrier exceeded investigation window without communication.
- Code Enforcement Citation. Denied Claim Guide.Code enforcement citation on property creates coverage complications.
- Collapse Definition Dispute. Denied Claim Guide.Florida policies define collapse narrowly.
- Contents Values Outdated. Denied Claim Guide.Carrier disputes contents values using outdated scheduled amounts.
- Contractor Assumption of Risk. Denied Claim Guide.Carrier alleges contractor terms shifted risk to contractor.
- Contractor Insurance Expired at Work Time. Denied Claim Guide.Carrier denies payment for work when contractor liability insurance lapsed.
- Contractor Not Licensed. Denied Claim Guide.Repairs performed by an unlicensed contractor; carrier refuses reimbursement per policy licensing clause.
- Coverage Limits Exceeded. Denied Claim Guide.Carrier pays only up to policy limit; damage exceeds that limit.
- Coverage Not In Force on Loss Date. Denied Claim Guide.Carrier claims specific coverage (flood, sinkhole, AOB) was not in force.
- Crawlspace Encapsulation Denied. Denied Claim Guide.Carrier won't pay for crawlspace encapsulation after water loss.
- Damage During Renovation. Denied Claim Guide.Carrier excludes damage during active construction.
- Damage Outside Policy Scope. Denied Claim Guide.Carrier denies specific damage elements as outside policy.
- Damage Spread to Uncovered Areas. Denied Claim Guide.Carrier refuses coverage when damage spread beyond initially covered zone.
- Delay Allowed Worsening Damage. Denied Claim Guide.Carrier blames insured for allowing damage to worsen.
- Delay in Repair Authorization. Denied Claim Guide.Carrier delays authorizing repair work.
- Delayed Filing Past Policy Window. Denied Claim Guide.Claim filed beyond policy notice requirement.
- Delayed FNOL Due to Evacuation. Denied Claim Guide.Carrier argues delayed FNOL exceeds reasonable window even during evacuation.
- Deliberate Neglect. Denied Claim Guide.Carrier alleges deliberate neglect by insured.
- Deposits Forfeited. Denied Claim Guide.Carrier refuses to credit deposits paid to contractors.
- Depreciation Applied to Non-Depreciable Items. Denied Claim Guide.Carrier depreciates items that policy doesn't allow.
- Diminished Value Denied. Denied Claim Guide.Carrier refuses compensation for value loss after repair.
- Divorce Not Disclosed. Denied Claim Guide.Carrier alleges divorce affected coverage but wasn't disclosed.
- Double Coverage Dispute. Denied Claim Guide.Multiple policies dispute primary coverage.
- Driveway Cracking Not Covered. Denied Claim Guide.Driveway damage from settling not covered.
- Emergency Mitigation Fees Excessive. Denied Claim Guide.Carrier claims mitigation charges were excessive.
- Engineer vs Contractor Scope Conflict. Denied Claim Guide.Carrier engineer and contractor disagree on scope.
- Engineering Reimbursement Denied. Denied Claim Guide.Carrier refuses to reimburse engineer fees.
- Equipment Breakdown Not Covered. Denied Claim Guide.HVAC or electrical breakdown not covered under homeowners.
- Escrow Held Repair Funds. Denied Claim Guide.Mortgage servicer won't release insurance proceeds from escrow.
- Exceeded Supplemental Claim Window. Denied Claim Guide.Carrier rejects supplemental claim as filed outside statutory window.
- Failure to Identify Driver. Denied Claim Guide.Carrier claims inability to identify at-fault driver defeats claim.
- Failure to Mitigate. Denied Claim Guide.Carrier claims you allowed damage to worsen.
- Flood Carrier Denied. Denied Claim Guide.NFIP or private flood denied claim.
- Flood Elevation Below Required. Denied Claim Guide.NFIP coverage denied for basement or below-elevation spaces.
- Flood Zone Changed Mid-Policy. Denied Claim Guide.FEMA reclassification affects coverage.
- Flood Zone Coverage Mandate. Denied Claim Guide.Lender required flood coverage in dispute at loss time.
- Foreclosure Affected Claim Rights. Denied Claim Guide.Carrier alleges foreclosure voided claim rights.
- Freezing Damage While Unoccupied. Denied Claim Guide.Pipe freeze damage while property was unoccupied and heat not maintained.
- Garage Floor Coating Damage. Denied Claim Guide.Specialty floor coating replacement undervalued.
- Hail Size Below Policy Threshold. Denied Claim Guide.Policy requires specific hail size for damage claim.
- Hurricane Deductible Applied Incorrectly. Denied Claim Guide.Carrier applied the hurricane deductible when a non-hurricane storm caused damage.
- Hurricane-Spawned Tornado Allocation. Denied Claim Guide.Tornado spawned by hurricane creates classification ambiguity.
- HVAC Age Restriction. Denied Claim Guide.Carrier denies HVAC replacement citing age-based policy exclusion.
- Impact Damage Pre-Dated Loss. Denied Claim Guide.Carrier claims current impact damage existed before the loss event.
- Improper Repairs by Previous Contractor. Denied Claim Guide.Carrier attributes current damage to prior contractor errors.
- Inaccurate Address on Policy. Denied Claim Guide.Carrier alleges policy covers a different property than the loss location.
- Inaccurate Weather Data Used. Denied Claim Guide.Carrier cites weather data that doesn't match conditions at loss location.
- Inspected Upon Underwriting and Not Covered. Denied Claim Guide.Carrier argues inspection at underwriting noted the defect.
- Inspection Conclusions Disputed. Denied Claim Guide.Carrier inspection reached different conclusions than homeowner's own experts.
- Insufficient Coverage Limits. Denied Claim Guide.Carrier pays only up to limit; damage exceeds.
- Insufficient Fire Report. Denied Claim Guide.Carrier rejects fire claim citing missing or incomplete fire marshal documentation.
- Insurable Interest Lost. Denied Claim Guide.Carrier claims insurable interest terminated before loss.
- Insured-Caused Damage. Denied Claim Guide.Carrier claims the insured intentionally or through gross negligence caused the loss.
- Insurer Dropped Coverage Before Payment. Denied Claim Guide.Carrier non-renewed or cancelled before paying claim.
- Lack of Forced Entry. Denied Claim Guide.Carrier claims no forced entry means no covered theft.
- Lack of Proper Mitigation. Denied Claim Guide.Carrier claims inadequate mitigation allowed damage to worsen.
- Land Subsidence vs Structural. Denied Claim Guide.Carrier distinguishes land subsidence (covered) from structural failure (not).
- Landscaping Plantings Sublimit. Denied Claim Guide.Tree and shrub damage capped per policy.
- Landscaping Sublimit. Denied Claim Guide.Carrier applies landscaping cap to mature or specimen plantings.
- Leak Source Not Identified. Denied Claim Guide.Carrier denies water claim citing failure to identify source.
- Liability Dispute Between Carriers. Denied Claim Guide.Your carrier and the at-fault party's carrier dispute liability.
- Light Fixture Downgrade. Denied Claim Guide.Builder-grade fixtures approved for high-end originals.
- Loss Control Inspection Required Before Payment. Denied Claim Guide.Carrier conditions payment on loss control inspection.
- Loss Not Accidental. Denied Claim Guide.Carrier alleges the loss was not accidental (foreseeable or intentional).
- Loss Outside Coverage Period. Denied Claim Guide.Carrier says loss occurred outside the policy period.
- Material Age Restriction. Denied Claim Guide.Carrier applies age-based exclusion to materials.
- Moving and Storage Denied. Denied Claim Guide.Carrier won't reimburse moving or storage costs.
- Mysterious Loss of Personal Property. Denied Claim Guide.Carrier invokes mystery-disappearance exclusion for lost items.
- Neighbor Had No Damage. Denied Claim Guide.Carrier claims absence of neighbor damage undermines your claim.
- Non-Disclosure of Use. Denied Claim Guide.Carrier alleges undisclosed use (Airbnb, long-term rental, etc.).
- Not a Peril Covered by This Policy. Denied Claim Guide.Carrier claims specific peril is outside policy scope.
- Not Catastrophic Ground Cover Collapse. Denied Claim Guide.Sinkhole activity classified as non-CGCC to limit coverage.
- Not Owner-Occupied at Loss. Denied Claim Guide.Carrier claims you were not living there at time of loss.
- Opening Cause Not Documented. Denied Claim Guide.Carrier denies wind-driven rain citing missing documentation of wind-created opening.
- Other Structures Sublimit. Denied Claim Guide.Carrier limits claim to Coverage B sublimit.
- Overflow vs Sewer Backup Dispute. Denied Claim Guide.Carrier classifies event as backup (excluded) rather than overflow (covered).
- Partial ALE Offer. Denied Claim Guide.Carrier offers insufficient additional living expense coverage.
- Partial Responsibility Attributed to Insured. Denied Claim Guide.Carrier attributes partial cause to insured's actions.
- Past Payment Deemed Insufficient. Denied Claim Guide.Carrier paid initial amount but refuses supplemental for newly discovered damage.
- Plumbing Fixture Downgrade. Denied Claim Guide.Builder-grade plumbing fixtures approved for high-end originals.
- Policy Cancelled for Cause. Denied Claim Guide.Carrier cancelled policy before loss based on cause (typically misrepresentation).
- Policy Form Mismatch. Denied Claim Guide.Carrier says the policy form doesn't cover this type of loss.
- Policy Lapsed Between Events. Denied Claim Guide.Gap between policies during damage progression.
- Policy Lapsed for Non-Payment. Denied Claim Guide.Carrier claims policy lapsed before the loss date.
- Policy Not Paid at Time of Loss. Denied Claim Guide.Carrier alleges premium was unpaid when loss occurred.
- Policy Unassigned Upon Sale. Denied Claim Guide.Property sale terminated policy but seller filed claim.
- Pool Heater Damage. Denied Claim Guide.Pool heater damage coverage disputed.
- Pool Resurfacing Denied. Denied Claim Guide.Pool surface damage not scoped for full resurfacing.
- Pre-Inspection Condition Unacceptable. Denied Claim Guide.Carrier claims pre-insurance inspection found issues.
- Previous Claim Affects Current Claim. Denied Claim Guide.Prior claim history impacts current claim.
- Property Disposition Denied. Denied Claim Guide.Carrier claims disposition of damaged property affected claim.
- Property Was Transferred. Denied Claim Guide.Carrier alleges ownership transfer voided coverage.
- Public Adjuster Qualifications Questioned. Denied Claim Guide.Carrier questions PA qualifications or licensing.
- Rainwater Through Vent Exclusion. Denied Claim Guide.Carrier claims rain entered through vent (excluded as maintenance).
- RCV vs ACV Wrong Application. Denied Claim Guide.Carrier applies ACV when RCV should apply.
- Reinsurance Capacity Reached. Denied Claim Guide.Rare but carrier claims reinsurance exhaustion.
- Rental Use Not Disclosed. Denied Claim Guide.Carrier claims property was rented but policy was written as owner-occupied.
- Repair Costs Below Deductible. Denied Claim Guide.Damage doesn't exceed deductible threshold.
- Repairs Made Without Carrier Consent. Denied Claim Guide.Carrier alleges unauthorized repairs defeated claim investigation.
- Replacement Cost Conditions Unmet. Denied Claim Guide.Carrier pays only ACV because RCV repair conditions weren't met.
- Replacement Cost Exceeds Limit. Denied Claim Guide.Rebuild cost exceeds Coverage A limit; carrier pays only to limit.
- Reservation of Rights Misuse. Denied Claim Guide.Carrier attempts to deny claim after improper reservation of rights.
- Scheduled Item Not Documented. Denied Claim Guide.Carrier denies scheduled item replacement due to documentation gaps.
- Scope Substantially Below Actual. Denied Claim Guide.Carrier scope is materially less than actual damage.
- Second Home Restriction. Denied Claim Guide.Policy restrictions apply to second/vacation homes.
- Sewer Backup Without Endorsement. Denied Claim Guide.Sewage or sump backup damage claimed without sewer backup endorsement.
- Sink Overflow Not Covered. Denied Claim Guide.Carrier excludes sink or toilet overflow damage.
- Sinkhole Testing Inconclusive. Denied Claim Guide.Carrier-selected geotechnical testing reports no sinkhole activity.
- Sinkhole Testing Not Required. Denied Claim Guide.Carrier denies testing under FS 627.706 citing insufficient triggering conditions.
- Slow Subrogation Processing. Denied Claim Guide.Your deductible reimbursement is delayed while your carrier pursues the at-fault party.
- Smoke Residue Not From Covered Fire. Denied Claim Guide.Carrier attributes smoke to non-covered source.
- Stain-Grade vs Paint-Grade Materials. Denied Claim Guide.Carrier authorizes paint-grade where stain-grade existed.
- Storm Surge vs Wind Causation. Denied Claim Guide.Wind and storm surge caused damage, but carriers dispute allocation.
- Stucco Cracking Denied as Settlement. Denied Claim Guide.Stucco cracks attributed to foundation settlement vs covered peril.
- Subcontractor Not Qualified. Denied Claim Guide.Carrier challenges subcontractor qualifications.
- Subrogation Failure Denies Recovery. Denied Claim Guide.Carrier argues failed subrogation affects insured recovery.
- Substandard Housing Classification. Denied Claim Guide.Carrier claims property was substandard at renewal.
- Temporary Housing Duration Capped. Denied Claim Guide.Carrier caps ALE duration.
- Total Loss Repair Rather Than Rebuild. Denied Claim Guide.Carrier proposes repair when total loss rebuild should apply.
- Tree Removal Sublimit. Denied Claim Guide.Carrier caps tree removal at policy sublimit.
- Unlicensed Contractor Repairs. Denied Claim Guide.Carrier refuses to reimburse repairs performed by unlicensed contractor.
- Unreasonable Scope of Repair. Denied Claim Guide.Carrier classifies necessary repair as excessive.
- Unscheduled Jewelry Sublimit. Denied Claim Guide.Carrier pays only the $1,500 sublimit for unscheduled jewelry.
- Upgrades Beyond Original Specification. Denied Claim Guide.Carrier refuses to pay for upgrades, classifying as betterment.
- Valid Civil Remedy Notice Ignored. Denied Claim Guide.Carrier failed to cure during 60-day CRN window.
- Vandalism Exclusion on Vacant Over 30 Days. Denied Claim Guide.Policy excludes vandalism on property vacant over a stated period.
- Vehicle Damage Not Covered Under Homeowners. Denied Claim Guide.Homeowners policy excludes damage to personal vehicles.
- Water Damage Category Dispute. Denied Claim Guide.Carrier disputes Category 2 or Category 3 water classification.
- Water from Landscape Sprinkler. Denied Claim Guide.Carrier excludes sprinkler-caused water damage.
- Wind Classification Dispute. Denied Claim Guide.Carrier classifies wind as insufficient for damage claimed.
- Wind-Driven Rain Not Covered. Denied Claim Guide.Carrier claims rain entered through pre-existing opening, not wind-created.
- Window Warranty Void Due to Age. Denied Claim Guide.Carrier disputes window replacement due to warranty/age issues.
- Work Done Without Permit. Denied Claim Guide.Carrier denies reimbursement for work requiring a permit but none obtained.
- Wrong Named Insured. Denied Claim Guide.Carrier alleges loss claimant is not the named insured.
- Wrong Policy Form Issued. Denied Claim Guide.Carrier issued a restrictive form (HO-2) when homeowner thought HO-3.
Carrier-Specific Behavior
96Patterns specific to particular carriers — known delay tactics and scope reductions you should expect.
- Allstate Delayed Response Pattern. Denied Claim Guide.Allstate: Carrier-specific pattern of delayed responses.
- Allstate Scope Reduction. Denied Claim Guide.Allstate: Carrier-specific scope reduction pattern.
- American Family Delayed Response Pattern. Denied Claim Guide.American Family: Carrier-specific pattern of delayed responses.
- American Family Scope Reduction. Denied Claim Guide.American Family: Carrier-specific scope reduction pattern.
- American Integrity Delayed Response Pattern. Denied Claim Guide.American Integrity: Carrier-specific pattern of delayed responses.
- American Integrity Scope Reduction. Denied Claim Guide.American Integrity: Carrier-specific scope reduction pattern.
- American Strategic Delayed Response Pattern. Denied Claim Guide.American Strategic: Carrier-specific pattern of delayed responses.
- American Strategic Scope Reduction. Denied Claim Guide.American Strategic: Carrier-specific scope reduction pattern.
- Aon Edge Delayed Response Pattern. Denied Claim Guide.Aon Edge: Carrier-specific pattern of delayed responses.
- Aon Edge Scope Reduction. Denied Claim Guide.Aon Edge: Carrier-specific scope reduction pattern.
- Auto Owners Delayed Response Pattern. Denied Claim Guide.Auto Owners: Carrier-specific pattern of delayed responses.
- Auto Owners Scope Reduction. Denied Claim Guide.Auto Owners: Carrier-specific scope reduction pattern.
- Avatar Delayed Response Pattern. Denied Claim Guide.Avatar: Carrier-specific pattern of delayed responses.
- Avatar Scope Reduction. Denied Claim Guide.Avatar: Carrier-specific scope reduction pattern.
- Chubb Delayed Response Pattern. Denied Claim Guide.Chubb: Carrier-specific pattern of delayed responses.
- Chubb Scope Reduction. Denied Claim Guide.Chubb: Carrier-specific scope reduction pattern.
- Citizens Delayed Response Pattern. Denied Claim Guide.Citizens: Carrier-specific pattern of delayed responses.
- Citizens Scope Reduction. Denied Claim Guide.Citizens: Carrier-specific scope reduction pattern.
- Cypress Delayed Response Pattern. Denied Claim Guide.Cypress: Carrier-specific pattern of delayed responses.
- Cypress Scope Reduction. Denied Claim Guide.Cypress: Carrier-specific scope reduction pattern.
- Edison Delayed Response Pattern. Denied Claim Guide.Edison: Carrier-specific pattern of delayed responses.
- Edison Scope Reduction. Denied Claim Guide.Edison: Carrier-specific scope reduction pattern.
- Encompass Delayed Response Pattern. Denied Claim Guide.Encompass: Carrier-specific pattern of delayed responses.
- Encompass Scope Reduction. Denied Claim Guide.Encompass: Carrier-specific scope reduction pattern.
- Farmers Delayed Response Pattern. Denied Claim Guide.Farmers: Carrier-specific pattern of delayed responses.
- Farmers Scope Reduction. Denied Claim Guide.Farmers: Carrier-specific scope reduction pattern.
- Florida Family Delayed Response Pattern. Denied Claim Guide.Florida Family: Carrier-specific pattern of delayed responses.
- Florida Family Scope Reduction. Denied Claim Guide.Florida Family: Carrier-specific scope reduction pattern.
- Florida Peninsula Delayed Response Pattern. Denied Claim Guide.Florida Peninsula: Carrier-specific pattern of delayed responses.
- Florida Peninsula Scope Reduction. Denied Claim Guide.Florida Peninsula: Carrier-specific scope reduction pattern.
- Foremost Delayed Response Pattern. Denied Claim Guide.Foremost: Carrier-specific pattern of delayed responses.
- Foremost Scope Reduction. Denied Claim Guide.Foremost: Carrier-specific scope reduction pattern.
- Frontline Delayed Response Pattern. Denied Claim Guide.Frontline: Carrier-specific pattern of delayed responses.
- Frontline Scope Reduction. Denied Claim Guide.Frontline: Carrier-specific scope reduction pattern.
- Geico Delayed Response Pattern. Denied Claim Guide.Geico: Carrier-specific pattern of delayed responses.
- Geico Scope Reduction. Denied Claim Guide.Geico: Carrier-specific scope reduction pattern.
- Hartford Delayed Response Pattern. Denied Claim Guide.Hartford: Carrier-specific pattern of delayed responses.
- Hartford Scope Reduction. Denied Claim Guide.Hartford: Carrier-specific scope reduction pattern.
- Hci Delayed Response Pattern. Denied Claim Guide.Hci: Carrier-specific pattern of delayed responses.
- Hci Scope Reduction. Denied Claim Guide.Hci: Carrier-specific scope reduction pattern.
- Heritage Delayed Response Pattern. Denied Claim Guide.Heritage: Carrier-specific pattern of delayed responses.
- Heritage Scope Reduction. Denied Claim Guide.Heritage: Carrier-specific scope reduction pattern.
- Homeowners Choice Delayed Response Pattern. Denied Claim Guide.Homeowners Choice: Carrier-specific pattern of delayed responses.
- Homeowners Choice Scope Reduction. Denied Claim Guide.Homeowners Choice: Carrier-specific scope reduction pattern.
- Kin Delayed Response Pattern. Denied Claim Guide.Kin: Carrier-specific pattern of delayed responses.
- Kin Scope Reduction. Denied Claim Guide.Kin: Carrier-specific scope reduction pattern.
- Lexington Delayed Response Pattern. Denied Claim Guide.Lexington: Carrier-specific pattern of delayed responses.
- Lexington Scope Reduction. Denied Claim Guide.Lexington: Carrier-specific scope reduction pattern.
- Liberty Mutual Delayed Response Pattern. Denied Claim Guide.Liberty Mutual: Carrier-specific pattern of delayed responses.
- Liberty Mutual Scope Reduction. Denied Claim Guide.Liberty Mutual: Carrier-specific scope reduction pattern.
- Lloyds London Delayed Response Pattern. Denied Claim Guide.Lloyds London: Carrier-specific pattern of delayed responses.
- Lloyds London Scope Reduction. Denied Claim Guide.Lloyds London: Carrier-specific scope reduction pattern.
- Mercury Delayed Response Pattern. Denied Claim Guide.Mercury: Carrier-specific pattern of delayed responses.
- Mercury Scope Reduction. Denied Claim Guide.Mercury: Carrier-specific scope reduction pattern.
- Metropolitan Delayed Response Pattern. Denied Claim Guide.Metropolitan: Carrier-specific pattern of delayed responses.
- Metropolitan Scope Reduction. Denied Claim Guide.Metropolitan: Carrier-specific scope reduction pattern.
- Nationwide Delayed Response Pattern. Denied Claim Guide.Nationwide: Carrier-specific pattern of delayed responses.
- Nationwide Scope Reduction. Denied Claim Guide.Nationwide: Carrier-specific scope reduction pattern.
- Neptune Delayed Response Pattern. Denied Claim Guide.Neptune: Carrier-specific pattern of delayed responses.
- Neptune Scope Reduction. Denied Claim Guide.Neptune: Carrier-specific scope reduction pattern.
- Nfip Delayed Response Pattern. Denied Claim Guide.Nfip: Carrier-specific pattern of delayed responses.
- Nfip Scope Reduction. Denied Claim Guide.Nfip: Carrier-specific scope reduction pattern.
- Olympus Delayed Response Pattern. Denied Claim Guide.Olympus: Carrier-specific pattern of delayed responses.
- Olympus Scope Reduction. Denied Claim Guide.Olympus: Carrier-specific scope reduction pattern.
- Orion180 Delayed Response Pattern. Denied Claim Guide.Orion180: Carrier-specific pattern of delayed responses.
- Orion180 Scope Reduction. Denied Claim Guide.Orion180: Carrier-specific scope reduction pattern.
- Peoples Trust Delayed Response Pattern. Denied Claim Guide.Peoples Trust: Carrier-specific pattern of delayed responses.
- Peoples Trust Scope Reduction. Denied Claim Guide.Peoples Trust: Carrier-specific scope reduction pattern.
- Progressive Delayed Response Pattern. Denied Claim Guide.Progressive: Carrier-specific pattern of delayed responses.
- Progressive Scope Reduction. Denied Claim Guide.Progressive: Carrier-specific scope reduction pattern.
- Safeco Delayed Response Pattern. Denied Claim Guide.Safeco: Carrier-specific pattern of delayed responses.
- Safeco Scope Reduction. Denied Claim Guide.Safeco: Carrier-specific scope reduction pattern.
- Scottsdale Delayed Response Pattern. Denied Claim Guide.Scottsdale: Carrier-specific pattern of delayed responses.
- Scottsdale Scope Reduction. Denied Claim Guide.Scottsdale: Carrier-specific scope reduction pattern.
- Security First Delayed Response Pattern. Denied Claim Guide.Security First: Carrier-specific pattern of delayed responses.
- Security First Scope Reduction. Denied Claim Guide.Security First: Carrier-specific scope reduction pattern.
- Slide Delayed Response Pattern. Denied Claim Guide.Slide: Carrier-specific pattern of delayed responses.
- Slide Scope Reduction. Denied Claim Guide.Slide: Carrier-specific scope reduction pattern.
- Southern Oak Delayed Response Pattern. Denied Claim Guide.Southern Oak: Carrier-specific pattern of delayed responses.
- Southern Oak Scope Reduction. Denied Claim Guide.Southern Oak: Carrier-specific scope reduction pattern.
- State Farm Delayed Response Pattern. Denied Claim Guide.State Farm: Carrier-specific pattern of delayed responses.
- State Farm Florida Delayed Response Pattern. Denied Claim Guide.State Farm Florida: Carrier-specific pattern of delayed responses.
- State Farm Florida Scope Reduction. Denied Claim Guide.State Farm Florida: Carrier-specific scope reduction pattern.
- State Farm Scope Reduction. Denied Claim Guide.State Farm: Carrier-specific scope reduction pattern.
- Tower Hill Prime Delayed Response Pattern. Denied Claim Guide.Tower Hill Prime: Carrier-specific pattern of delayed responses.
- Tower Hill Prime Scope Reduction. Denied Claim Guide.Tower Hill Prime: Carrier-specific scope reduction pattern.
- Travelers Delayed Response Pattern. Denied Claim Guide.Travelers: Carrier-specific pattern of delayed responses.
- Travelers Scope Reduction. Denied Claim Guide.Travelers: Carrier-specific scope reduction pattern.
- Typtap Delayed Response Pattern. Denied Claim Guide.Typtap: Carrier-specific pattern of delayed responses.
- Typtap Scope Reduction. Denied Claim Guide.Typtap: Carrier-specific scope reduction pattern.
- Universal Property Delayed Response Pattern. Denied Claim Guide.Universal Property: Carrier-specific pattern of delayed responses.
- Universal Property Scope Reduction. Denied Claim Guide.Universal Property: Carrier-specific scope reduction pattern.
- Usaa Delayed Response Pattern. Denied Claim Guide.Usaa: Carrier-specific pattern of delayed responses.
- Usaa Scope Reduction. Denied Claim Guide.Usaa: Carrier-specific scope reduction pattern.
- Wright Flood Delayed Response Pattern. Denied Claim Guide.Wright Flood: Carrier-specific pattern of delayed responses.
- Wright Flood Scope Reduction. Denied Claim Guide.Wright Flood: Carrier-specific scope reduction pattern.
Guías en Español
5Las razones más comunes de denegación, explicadas en español.
- Daño Preexistente. Guía de Reclamo Denegado.Aseguradora dice que el daño existía antes del período de la póliza o del evento de pérdida.
- Deducible de Huracán Aplicado Incorrectamente. Guía de Reclamo Denegado.Aseguradora aplicó el deducible de huracán cuando una tormenta no-huracán causó el daño.
- Desgaste Normal. Guía de Reclamo Denegado.La denegación más frecuentemente mal aplicada. La aseguradora dice que su daño fue desgaste preexistente.
- Lluvia Impulsada por Viento No Cubierta. Guía de Reclamo Denegado.Aseguradora dice que la lluvia entró por una abertura preexistente, no creada por viento.
- Reparación Parcial de Techo Denegada (Sin Coincidencia). Guía de Reclamo Denegado.Aseguradora autoriza reparación parcial que no puede igualar el techo existente.
Free claim review
Denied does not mean done. Let a licensed Florida adjuster look at it.
We review your policy and estimate at no cost. If we take your case, our fee only comes from the increased recovery.
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- ✓We work for policyholders, not insurance companies
- ✓No fee unless we recover more than you were offered
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