Insurance Claim Denied? What to Do Next (Step by Step)

If your home insurance claim was denied, start by reading the denial letter to find the exact reason and the policy language the insurer relied on. Then gather evidence that answers that reason, ask for the insurer's documents, and respond in writing before any deadline runs out.

Denials are common. Weiss Ratings, using insurer data, reported that U.S. home insurers closed about 42% of homeowner claims without payment in 2024 ↗, up from 39% in 2023. Some of those claims are closed for valid reasons, such as damage below the deductible. Still, a denial is a decision you can question.

Step 1: Read the denial letter carefully

Your denial letter should tell you why the claim was denied. Look for:

• The reason. Was it "not covered," "excluded," "wear and tear," "late notice," "damage below deductible" or "not enough information"?
• The policy section quoted. Find that exact wording in your own policy.
• Full or partial denial. Sometimes part of the claim is paid and part is denied.
• Deadlines or next steps. Some letters mention how to ask for review.

If the insurer only told you over the phone, ask for the denial in writing. The National Association of Insurance Commissioners (NAIC) ↗ recommends this.

Some states require detail. In California, a written denial must give the factual and legal reasons, cite the policy provision relied on, and tell you that you can have the denial reviewed by the California Department of Insurance (10 CCR 2695.7 ↗). In Florida, insurers must give a written, reasonable explanation of any denial or partial denial (Fla. Stat. 627.70131 ↗). Rules differ, so check your state's page.

Step 2: Request your policy and claim documents

You cannot answer a denial well without seeing what the insurer saw. Ask in writing for:

• A complete, certified copy of your policy, including all endorsements
• The adjuster's estimate and photos
• Any engineer, roofer or other expert reports
• The specific policy language behind the denial

Some states give you a right to certain documents. Florida requires insurers to send you any detailed estimate within 7 days after their adjuster creates it (627.70131 ↗). California requires insurers to give you a copy of each estimate or scope the settlement is based on (10 CCR 2695.9 ↗). Not every state requires an insurer to hand over its whole claim file, but asking is always reasonable.

Step 3: Gather evidence that answers the denial reason

Match your evidence to the reason given:

• "Wear and tear" or "pre-existing damage": Older photos, inspection reports, repair receipts and a contractor's opinion on what caused the damage.
• "Excluded cause": An independent expert report on the cause of loss.
• "Late notice": Proof of when you found the damage and when you reported it.
• "Not enough information": Send what was requested and keep proof you sent it.

Keep a log of every call: date, time, who you spoke to and what they said. The NAIC suggests keeping emails and a call log in case you need to file a complaint ↗.

Step 4: Ask for reconsideration in writing

Most insurers will review new information. Write a short letter that includes:

• Your name, policy number, claim number and date of loss
• Each reason for denial, followed by your response and evidence
• What you want: reopen and pay the claim, or reinspect the property
• A date by which you'd like a written reply

Send it in a way you can track, and keep copies of everything. Be factual and calm. Your letter may later be read by a regulator, appraiser or attorney.

Step 5: Know when appraisal applies

Many homeowners policies include an appraisal clause. Appraisal is for disputes about the amount of a loss, not whether the loss is covered at all. The Texas Department of Insurance ↗ explains that the umpire's decision is binding and that you pay your own appraiser plus half the umpire's costs.

So if your claim was fully denied as "not covered," appraisal usually is not the right tool. If the insurer agreed some damage is covered but paid far too little, see our guide on disputing a low insurance offer. United Policyholders ↗ notes that appraisal can be fast and useful in the right case but can also get costly.

Step 6: File a complaint with your state insurance department

If the insurer won't budge, or is slow or unresponsive, you can file a free complaint with your state insurance department. The NAIC ↗ lists every state's department. Delays, denials and unfair settlements are among the most common complaint reasons, according to the NAIC ↗.

A regulator can check whether the insurer followed state claim-handling rules. A complaint does not guarantee the decision will change, and regulators generally cannot act as your lawyer.

Some states also offer mediation. Florida runs a property insurance mediation program through its Department of Financial Services, and the insurer pays the cost of the mediation conference (Fla. Stat. 627.7015 ↗).

Watch your deadlines

Deadlines can end your options, so write them down. They vary by state and policy. Examples:

• Reporting a claim: In Florida, notice of a new or reopened claim must be given within 1 year of the date of loss, and a supplemental claim within 18 months (627.70132 ↗). The Texas Department of Insurance says some policies have a one-year deadline ↗ to file unless you show good cause.
• Insurer decisions: Texas insurers generally must accept or reject a claim within 15 business days after getting what they need from you, with a possible 45-day extension (TDI ↗). California insurers generally have 40 days after proof of claim (10 CCR 2695.7 ↗). Florida insurers generally must pay or deny within 60 days of notice (627.70131 ↗).
• Lawsuits: Most policies have a "suit against us" clause that limits how long you have to sue. State law may change that limit. Check your policy and talk to an attorney well before it runs out.

When to get a public adjuster or an attorney

A public adjuster is a licensed professional who works for you, not the insurer, to document and negotiate a claim. You can browse licensed public adjusters in your area. A PA may help when the claim is large, the damage is hard to measure, or the insurer underpaid after accepting coverage. A Florida legislative study found that Citizens Property Insurance claims with public adjusters took longer to settle but received higher payments (OPPAGA Report 10-06 ↗). That study did not prove the adjusters caused the higher payments, and results in your case may differ.

A PA may not be worth it when:

• The claim is small, since fees are often a percentage of what you recover. Florida caps PA fees at 20%, or 10% for claims in the first year after a declared emergency (626.854 ↗). Other states have different rules or no cap.
• The insurer already offered a fair amount and the issue is simple.
• The dispute is purely about policy wording or coverage.

An attorney is the right call if you are thinking about a lawsuit, believe the insurer acted in bad faith, are near a lawsuit deadline, or the denial turns on what your policy language means. This guide is general information, not legal advice.

If your claim is large or complex and you want an expert on your side, Get matched with a licensed public adjuster.

Frequently asked questions

Can I reopen a denied insurance claim?

Often, yes. Many insurers will reconsider if you send new evidence, such as an independent estimate or expert report. Some states set deadlines for reopened or supplemental claims. In Florida, for example, a reopened claim must be reported within 1 year of the date of loss (627.70132 ↗).

Does filing a complaint with the state cost anything?

No. State insurance department complaints are free. Find your department through the NAIC ↗.

Can I use appraisal if my claim was denied?

Usually not for a full coverage denial. Appraisal settles disagreements over the amount of a covered loss, not whether the loss is covered (TDI ↗). Read your policy's appraisal clause.

How long does the insurer have to decide my claim?

It depends on your state. Examples: about 40 days after proof of claim in California, 60 days after notice in Florida, and 15 business days after receiving needed information in Texas, with extensions allowed in some cases. See your state's page for details.

Should I hire a public adjuster or a lawyer?

A public adjuster helps document and value a claim and negotiate the amount. A lawyer handles lawsuits, bad-faith claims and disputes over policy wording. For a small or simple claim, you may not need either.

Will a denial raise my premium?

It depends on your insurer and state. Ask your agent or state insurance department how claims history is used where you live.