10 COMMON REASONS WHY YOUR INSURANCE CLAIM MIGHT BE DENIED

It can be frustrating when your insurance provider denies a claim you thought was valid. Understanding the typical reasons behind this can help you avoid problems and secure the coverage you deserve.

1. Inadequate coverage
Make sure the type of insurance you have matches the specific risks you face. For example, a basic liability policy might not cover certain specialised activities or expensive types of damage. Researching and selecting appropriate coverage is crucial.

2. Failure to follow procedures
Insurance contracts contain clear instructions on how to report a claim. This includes deadlines, who to contact and the specific documentation required. Not adhering to these processes can jeopardise a claim.

3. Admitting liability
Avoid immediately acknowledging fault after an incident. This can complicate the claim process or result in an outright denial. Your insurer will usually advise you on how to handle the situation without admitting liability prematurely.

4. Reporting outside timeframes
Know the difference between ‘claims made’ and ‘claims occurring’ policies.
‘Claims made’ policies limit coverage to incidents reported within the policy period.
‘Claims occurring’ policies offer broader protection but may still have reporting deadlines.

5. Incomplete or inaccurate information
Omitting key details or providing misleading information when obtaining your policy can invalidate claims. Be thorough and upfront with your insurer from the start. This includes reporting any significant changes in your business operations.

6. Unavoidable exclusions
All insurance policies have exclusions for events or situations not covered. Understand your policy’s specific exclusions so you don’t expect compensation for those scenarios.

7. Failure to meet the policy’s requirements
If the claim involves damage not covered by your policy (for example, simple wear and tear), then it’s likely to be denied. Carefully review what your policy promises to cover.

8. Negligence
Insurers expect reasonable care to prevent loss or damage. If they deem you took inadequate steps to avoid the incident, they could reject the claim. Implementing good risk management practices shows your commitment to responsible business operations.

9. Insufficient supporting evidence
Claims usually require documentation. This may include photos, police reports or receipts. Lack of solid evidence can hinder your ability to prove a claim’s validity.

10. Geographical restrictions
Insurance policies often have specific locations where they provide coverage. If an incident occurs outside those defined areas, you may not be protected.

 

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