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'No maintenance' one excuse for insurance claim denial

The law does not require that insurance companies to honor all homeowners’ claims, only that they operate in good faith. This means that insurers must have a legitimate reason for offering a settlement that is less than what the insured party believes they are entitled to, or rejecting the claim entirely.

When your roof is damaged by bad weather, it is important that you get a fair settlement from your insurance company as soon as possible, so you can get repairs started. But your insurer will likely seek any excuse to lowball you -- legitimate or otherwise.

One reason an insurer might reject a claim for a damaged roof is that the homeowner supposedly did not keep the roof maintained before the severe weather hit. The adjuster who inspects the property might claim that the damage was a “maintenance issue.”

This can include leaves or needles from a nearby tree the piled up on the room. That was the excuse that an insurer told one homeowner from outside of Florida. The homeowner filed a claim after a monsoon-level storm caused his roof to leak, damaging his interior walls.

After an inspection, the adjuster told the homeowner that clumps of pine needles had caused water from the storm to pool on the roof. His claim was thus denied.

The lesson of stories like this is that it is important to understand the terms of your insurance policy. That way, you know what is supposed to be covered and what is not. If you then are denied a claim, you will have good reason to believe that the denial is in bad faith.

Source: KPHO-TV, “Check out roof for leaks or insurance claims can be denied,” Dave Cherry, Oct. 28, 2014

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