ClaimsTruth

Foundation

Why Claims Get Denied

The most common reasons insurance claims are denied and what each reason actually means.

Definition

A claim denial is a formal determination by the insurance carrier that the claimed loss is not covered under the policy. Denials are communicated in writing and must cite the specific policy language or reason for the denial.

Common Denial Reasons

Wear and tear exclusion

Policy Language

Late reporting

Industry Practice

Insufficient documentation

Industry Practice

What Should Happen Next

If your claim was denied, request the full denial letter with the specific policy language cited. Compare that language against your actual policy. If the denial is incorrect or the language is ambiguous, you may have grounds for an appeal.

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