Reasons Why Claims Made Under Commercial Policies Are Denied

Fri Dec 15th, 2023 on     Bad Faith Insurance,    

If you are a business owner or manager, you need to be able to depend on the coverage provided by your commercial insurance policies. There are many reasons why your claim may be denied or delayed. While some of these delays and denials are legitimate, others are not. When claims you make under these policies are unfairly denied or delayed, a Miami insurance claim lawyer from our firm can assist you in having your claim paid. If you have questions about your insurer’s failure to pay your claim when due, contact us to see how we can help. 

Insufficient or Inadequate Documentation of Damage

It is necessary to provide sufficient and adequate documentation of damages that your business has incurred to the insurer. Failure to provide this documentation can result in a denial of your claim. Documentation can include a wide variety of items, including photographs, police reports, or inventory lists. If the insurer does not feel that the documentation you provide proves the damages you are claiming, they will deny your claim. A Miami insurance claim lawyer from Ver Ploeg & Marino can help determine whether or not your denial or delay was made in bad faith

Failing to Mitigate Damages

When your business suffers damages, you have a duty to mitigate damages when possible. This means that you should make a reasonable effort to limit the damages that have occurred. This does not place you under any obligation to perform permanent repairs nor should you. Rather, it means that you need to take steps that will prevent any further damage from occurring. For example, if the claim is for damages sustained to the business during a hurricane and part of the roof has been removed, once the hurricane is over and you can safely do so, you should cover the damaged area with a sheet of plastic to prevent further water damage. 

Failing to Promptly File the Claim

While you may want to delay filing your claim under your commercial insurance policy, this can be to your detriment. You should immediately check the terms of your policy to determine the time frame it gives for filing. Many policies will state that your claim should be filed “promptly.” Although what is considered to be prompt is up for interpretation, our Miami insurance claim lawyer believes you should make the claim as soon as possible as failing to do so can be used as a reason for denial. 

Failing to Properly File the Claim

There are certain steps that should be taken when filing a claim under a commercial insurance policy and a failure to comply with proper procedure can result in a claim denial. If your claim is denied, ask the insurer to provide you with the reason for the denial in writing. This documentation will be helpful when meeting with a Miami insurance claim lawyer to find out if your denial was proper or improper.   

Failing to Properly Maintain Property

Part of owning business property means taking care of the property to prevent it from becoming damaged. If you fail to perform routine maintenance on your property and that failure results in your property being damaged, you are unable to recover for those damages under your insurance policy. One issue that is often hotly contested is roof damage. While you, the insured, may claim that a hailstorm caused the damage incurred by your business’s roof, your insurer may claim it was instead due to the roof’s age and lack of maintenance. Whether or not a denial based on failure to maintain the property is valid is a matter to discuss with a Miami insurance claim lawyer from Ver Ploeg & Marino.  

Failing to Cooperate with Insurer

The insurer is entitled to conduct an investigation into your claim. If you do not cooperate with that investigation or try to hinder their ability to investigate your claim may be denied. However, insurance companies sometimes attempt to abuse this power and claim that an insurer is failing to cooperate when they are being cooperative. When this happens, it is best to speak with a Miami insurance claim lawyer from Ver Ploeg and Marino.

Damage Sustained Is Excluded Under Terms of Policy

Not all damage is covered by every policy. Actually, most policies contain many exclusions. If your damage falls under one of these exclusions, your claim will be denied by your insurer. Common examples include damage caused by a flood or an earthquake. You need to familiarize yourself with all of the exclusions listed in your policy so that you will know what is and is not covered and whether or not you need additional insurance to fully meet the needs of your business. 

Policy Has Lapsed Or Nonpayment of Premiums

Insurance policies can lapse due to nonpayment of premiums or for late payment of premiums. If you file a claim for damages during a period of time when the policy has lapsed, your claim will be denied by the insurer. Because of this, it is imperative that you stay current on all payments to prevent a lapse in coverage. 

Loss Is Considered to be Consequential

Some commercial insurance policies only cover damage that is direct and not those that occur as a result of the initial event. For example, if your business is impacted by a natural disaster that damages the business, and that damage is covered by the policy, the natural disaster is the initial event. However, in some policies, the resulting financial losses sustained by your business’s inability to operate for a period of time due to the damages may not be covered as a consequential loss. 

Consult With A Miami Insurance Claim Lawyer at Ver Ploeg & Marino

If the claim you made under your business’s commercial policy is denied, contact Ver Ploeg & Marino to schedule a consultation with a Miami insurance claim lawyer. We are legal professionals dedicated to representing policyholders who have had their claims improperly delayed or denied.

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