When a claim is denied

Common reasons

• The loss falls under an exclusion
• The coverage wasn't carried — no collision, for example
• Late notice, breaching the policy's notification condition
• The policy had lapsed at the time of loss
• A dispute about fault
• Material misrepresentation on the application
• Damage attributed to wear or a pre-existing condition rather than the incident

What to ask for

• The denial in writing
• The specific policy provision relied on
• The documents and evidence the decision was based on
• The name of the adjuster and their supervisor
• The insurer's internal appeal process

If the dispute is about amount, not coverage

Most auto policies contain an appraisal provision: each side appoints an appraiser, and if they disagree an umpire decides. It's designed for exactly this and is usually faster and cheaper than the alternatives.

It applies to the value of a loss, not to whether something is covered at all.

Escalating

Your state insurance department accepts complaints and is the body that compiles the complaint index used to compare insurers. Filing costs nothing.

For substantial disputes, particularly involving injury, legal advice is worth taking. Note that policies and state law contain time limits for bringing action.