While facing water damage in New York, the most overwhelming and stressful situation occurs when the water damage claim is denied. There are various reasons behind the denial, and you must understand them to take appropriate steps to alter the decision. The first thing you have to do is go through the detailed documentation that holds the reason for rejection and, based on which, you have to formulate a response.

So, let’s get to the root and help you understand the reasons behind denial and your response in such a situation to reverse the process.

• What are the reasons for claim denial?

The most common grounds for denying a water damage mold insurance claim are lack of maintenance, as it is the homeowner’s responsibility to maintain the property well. A standard water damage claim does not cover gradual leakage. Also, if there is a fault in maintenance or errors in the claimed documentation, the claim is labeled as incorrect or failed.

• What are the limitations and exclusions of a water damage claim?

While getting water damage insurance, you should always review the specifications and the list of limitations and exclusions. All types of water damage are not covered through insurance. If there is long-term leakage, then a separate set of flood insurance claims would be required. The most common exclusions are damages from flood-related issues, seepage, or ongoing leaks. There is also a time limitation, based on which you have to report the incident, and failure to do so can lead to claim denial. Thus, you must check the policy’s declaration page and the points that will help you assess the claim’s validity.

• How do you respond to claim denial?

When you receive a claim denial notification, you have to act swiftly, and here are the steps you need to take:

1. Prepare the documentation and gather all the photographs and videos you have taken immediately after discovering the water damage.
2. Keep a copy of the insurance policy to state the coverages. Get a detailed estimation of the repair cost from the licensed contractors.
3. Arrange the communication log with the insurance in chronological order. Every documentation should be clear, organized and support your chest
4. Navigate through the appeal process, go through the denial letter, and understand all the reasoning stated by the insurer. Additionally, ask – does renters insurance cover water leak damage?
5. Submit a written application where you would outline the points that the insurer has to reconsider. You may also include the documentation as stated above.
6. Always stick by the timeline mentioned in the policies so that no further argument can arise.

• Consulting with a legal professional 

If your appeal is still denied, you can consult with an attorney with insurance law experience. They can go through your claim and talk to the insurer on your behalf. They can also negotiate with the insurance adjuster to reach a successful appeal.

Final words

Before you respond to any denial, you must be equipped with your response. Communication should always be clear, and there should not be any requirement for revaluation. You can get help from professionals who can guide you throughout the process, but remember to file the claim in a timely manner, which is crucial to meeting the damages and repair expenses.