Why would insurance deny a homeowners claim?
Short answer. Insurance typically denies a home claim because the cause is excluded (flood, earth movement, wear, mold, pests), the policy was not in force, or the loss predates the policy. Denials also follow when the homeowner did not meet a policy duty such as prompt notice or protecting the property, or when facts on the application or claim were misstated.
Coverage reasons
- Excluded perils. Standard homeowners policies exclude flood, earth movement, wear and tear, deterioration, rot, insects and rodents, and usually gradual leaks. Flood needs its own policy.
- Limited property. Some items and structures carry special limits or are excluded.
- Outside the policy period. The damage happened before coverage began or after it ended.
Policy duty reasons
- Late notice. Most policies require prompt notice, and a long delay can justify a denial if it hurt the insurer's ability to investigate.
- Failure to mitigate. You are expected to take reasonable steps, like a tarp, to stop further damage. See the duty to mitigate.
- Not cooperating. Refusing an inspection, an examination or a document request.
- Vacancy. Many policies limit coverage once a home has sat vacant past a set period.
Honesty reasons
Misrepresenting facts on the application or the claim, such as the roof's age, a prior loss or the cause of damage, can void coverage. Going along with a contractor's offer to cover your deductible is illegal in Georgia and can taint the whole claim.
Money reasons
If the covered damage costs less than the deductible, nothing is paid. That is often described as a denial even though coverage was accepted.
For roof-specific reasons, see wear and tear vs hail damage and what to do after a roof claim denial.