DENIED PROPERTY CLAIMS

Common reasons insurers give

• The damage is wear and tear, age or a maintenance problem, not a storm.
• The damage was caused by flood, which the homeowners policy excludes.
• The loss was reported late.
• The damage is below the deductible, including a hurricane or named storm deductible.
• Missing documents or an incomplete proof of loss.

Steps after a denial

• Get the denial in writing, with the policy language the insurer relies on.
• Get a full copy of your policy, including endorsements and the declarations page.
• Get your own estimate from a licensed contractor.
• For storm damage, find the dated NOAA storm report for your area. Our South Carolina areas pages list storm records by city.
• Do not miss the 3-year limit to sue on the policy (S.C. Code § 15-3-530(8)). See claim deadlines.

Options

• Ask the insurer to reconsider, with your evidence.
• Invoke appraisal if the dispute is about the amount, not coverage. See insurance appraisal.
• File a complaint with the South Carolina Department of Insurance (803-737-6180).
• Sue on the policy, and for bad faith where the facts support it. See insurance bad faith.

Denied claims we handle

Hurricane, wind, fire, mold, theft, roof, hail and water damage.

Partial denials and underpayment

Many claims are not denied outright. The insurer accepts the claim but pays for part of the damage, or pays an amount far below the repair cost. Common causes: a narrow scope of repair, low unit prices, depreciation on an actual cash value policy, or a deductible larger than expected. An underpaid claim can be challenged the same ways as a denial.

Reading your denial letter

• Which policy section, exclusion or condition does the insurer cite? Find it in your policy.
• Does the letter say what evidence the insurer relied on, such as an engineer’s report? Ask for a copy.
• Does the letter invite more information? Send it, in writing, and keep proof.
• Does it mention appraisal or a deadline? Note the dates.

Wind or water: the most common storm dispute

Most homeowners policies cover wind and exclude flood. After a hurricane or tropical storm, insurers often say damage came from rising water rather than wind. Evidence of wind damage, such as roof and window damage above the water line, and the timing of the storm matter. Flood damage is claimed under a separate flood policy, which follows federal rules and shorter deadlines.

Business and association claims

Commercial, condo and HOA claims add issues: business income and extra expense, coinsurance, multiple buildings, and the split between the association’s master policy and owners’ unit policies. See business interruption and condo and HOA claims.

Questions about a claim? Call 843-284-5790 or request a case review.

This page is general information about South Carolina law, not legal advice. Reading it does not create an attorney-client relationship. Every claim depends on its own policy and facts.