One of the most frustrating experiences a homeowner can face is filing a claim for property damage—only to be denied by their insurance company. Whether it’s roof damage after a storm, water damage from a burst pipe, or fire damage to your home, getting a denial letter can feel like a punch to the gut.
As a licensed Public Insurance Adjuster, I’ve reviewed hundreds of denied claims. In many cases, the denial wasn’t because the damage wasn’t real—it was because of how the claim was filed, what was (or wasn’t) documented, or how the insurance company interpreted the policy.
Here are some of the most common reasons home insurance claims get denied—and what you can do if it happens to you.
1. “Wear and Tear” or Lack of Maintenance
What They Say:
“Your damage was caused by wear and tear, not a covered peril.”
What It Means:
Insurance policies typically cover sudden and accidental damage—not damage caused by aging, deterioration, or neglect. So if your roof leaks due to old shingles, they may say it’s maintenance-related—even if a storm contributed.
What You Can Do:
Get a second opinion from a Public Adjuster or licensed contractor. In many cases, insurers misclassify wind or hail damage as wear and tear. A proper inspection can often prove otherwise.
2. “Late Reporting” of Damage
What They Say:
“You failed to notify us of the damage in a timely manner.”
What It Means:
Most policies require that you report a loss “promptly.” If you wait weeks or months to report damage, the insurer may argue they can’t accurately assess the cause or extent.
What You Can Do:
Even if time has passed, don’t panic. If you didn’t know about the damage until later (such as a slow roof leak), you may still have a valid claim. A Public Adjuster can help build your case and explain the delay.
3. “Damage Not Covered by the Policy”
What They Say:
“The type of damage you experienced isn’t covered under your policy.”
What It Means:
Policies vary widely—some cover water damage from a burst pipe but exclude water that seeps in from outside. Others may exclude certain roof repairs or cosmetic damage.
What You Can Do:
Let a Public Adjuster review your policy and the insurer’s reasoning. Sometimes, they overlook endorsements or use vague language that doesn’t hold up under scrutiny.
4. “Pre-Existing Damage”
What They Say:
“The damage was already there before the event you reported.”
What It Means:
If you file a claim after a storm but the insurer believes the damage existed beforehand, they may deny it as unrelated.
What You Can Do:
Photographic evidence (from inspections or even Google Street View), weather reports, and expert analysis can show when the damage likely occurred. A Public Adjuster can help you compile this documentation.
5. “Insufficient Documentation”
What They Say:
“There’s not enough evidence to support your claim.”
What It Means:
Claims live and die by the documentation. If you didn’t provide detailed photos, repair estimates, or proof of damage, the insurer may use that as a reason to deny your claim.
What You Can Do:
Never file a claim without thorough documentation. If you’ve already been denied, a Public Adjuster can conduct a full inspection and create a detailed, evidence-backed estimate to resubmit.
6. “No Direct Physical Loss”
What They Say:
“There was no direct physical loss to your property.”
What It Means:
This is a common tactic when your damage is more subtle—like wind-lifted shingles or unseen water damage behind walls. They argue that because they can’t “see” it, it doesn’t count.
What You Can Do:
Hire an expert. We use moisture meters, drones, thermal imaging, and professional inspection tools to detect damage the naked eye can’t. Then, we help you file (or refile) your claim with strong evidence.
What to Do If Your Claim Was Denied
- Don’t accept the denial as final.
Insurance companies deny claims all the time—but that doesn’t mean they’re right. You have the right to appeal or dispute the decision. - Get a copy of the denial letter and full claim file.
This will show the insurer’s reasoning and give your Public Adjuster what they need to build a case. - Call a Public Adjuster (like me) immediately.
We’ll review your policy, your damage, and the insurance company’s denial. If your claim was unfairly denied, we’ll help you fight back—and we only get paid if you do.
You Don’t Have to Fight the Insurance Company Alone
Claim denials are frustrating—but they’re not the end of the road. If you believe your damage is legitimate and your policy should cover it, don’t give up. Many of the homeowners I’ve helped were initially told “no”—until we got them the settlement they were owed.
📞 Call David Kanter Public Insurance Adjuster today for a free claim review.
We’ll give you an honest answer and a real plan for moving forward.