Tips for Handling Insurance Claim Denials Effectively

Insurance claim denials can feel like a punch to the gut. You’ve suffered a loss, done everything right, and now your insurer is refusing to pay. But a denial doesn’t mean it’s over. With the right strategy—and the right legal team—you may be able to turn things around. At Daly & Black, P.C., we help policyholders across Texas and Louisiana fight back against denied insurance claims and pursue the full compensation they may be entitled to.

Why Do Insurance Claim Denials Happen?

It is becoming increasingly clear that denials aren’t just occasional setbacks; they are part of a growing trend. According to Weiss Ratings, the percentage of homeowner claims denied with no payment has surged from 25.8% in 2004 to 41.9% in 2024. 

Understanding why your claim was denied is the first step toward challenging it and leveling the playing field.

Policy Exclusions

Insurance companies rely heavily on fine print to avoid paying claims. Many policies contain exclusions that can be used to deny coverage, sometimes in ways policyholders don’t expect. For example, most homeowners insurance policies exclude flood damage unless you have a separate flood policy through the NFIP. 

Insurers may also try to categorize your loss under an uncovered peril or argue that the damage was pre-existing.

Incomplete Documentation

If your claim is missing essential documents like receipts, photographs, medical records, or expert estimates, insurers may use that gap as a justification for denial. 

Even minor omissions can lead to delays or outright denials. Detailed, timely, and accurate documentation is critical for supporting your claim and reducing pushback.

Late Filing

Insurance policies typically include strict deadlines for reporting a loss and submitting proof of damages. If you miss these timeframes, even by a few days, the insurer may deny your claim based on “noncompliance.” 

This is why it’s crucial to act immediately after any incident and to maintain records of your communications.

Disputed Cause of Loss

Insurers may challenge the underlying cause of damage to avoid paying. For instance, they might claim that the issue was caused by wear and tear, poor maintenance, or gradual deterioration, all of which are commonly excluded from coverage. 

Proving that the damage was sudden and caused by a covered event can make or break your claim.

Bad Faith Tactics

Unfortunately, some insurance companies engage in deceptive practices to protect profits. These “bad faith” tactics include unjustified delays, lowball offers, or blanket denials with little explanation. 

If your claim feels unfairly handled, you may be dealing with a bad faith insurer.

How to Respond After a Denied Insurance Claim

A denial doesn’t have to be the final word. Here’s how to start pushing back:

Review the Denial Letter Carefully

Read the insurer’s letter in full. Look for their stated reasons for denial, references to specific policy exclusions, or requests for additional documentation. These details are key to building your rebuttal.

Gather Supporting Documentation

Start compiling any evidence that strengthens your claim. This might include:

• Photos or videos of the damage
• Expert assessments (e.g., contractors, medical professionals)
• Medical records or invoices
• Policy declarations and coverage statements

Contact the Insurance Adjuster (But Cautiously)

You may be tempted to call and plead your case—but be careful. Stick to written communication when possible, and don’t say anything that could be twisted into an admission of fault or fraud.

Consult an Insurance Claim Denial Attorney

This is where Daly & Black steps in. We’ll examine the denial letter, review your policy, identify bad faith tactics, and develop a strategy to pursue what you’re rightfully owed. Whether that means negotiation or litigation—we’re ALL IN. ALL THE TIME.

How to Successfully Appeal an Insurance Denial

If your insurer offers an internal appeal process, don’t delay. These processes often have strict deadlines, sometimes as short as 30 to 60 days from the date of denial.

Submit a Written Appeal

Prepare a detailed, well-documented appeal letter outlining exactly why the denial was wrong. Reference specific policy language, correct any misunderstandings, and address the reasons listed in the denial letter. 

Be concise, factual, and focused—your appeal should read like a rebuttal, not an emotional plea.

Use Expert Support

Your appeal gains strength when backed by authoritative opinions. Attach contractor estimates, damage appraisals, structural assessments, or medical records that directly counter the insurer’s reasoning. 

Having professionals weigh in on the validity of your claim lends credibility.

Escalate if Needed

If your internal appeal is denied or ignored, don’t stop there. You have the right to escalate the matter to your state’s insurance regulator. In Texas, that means the Texas Department of Insurance; in Louisiana, it’s the Louisiana Department of Insurance. 

These agencies can investigate bad faith practices, compel responses, or open the door to legal remedies. 

An attorney can guide you through this escalation effectively. With a seasoned insurance claim denial attorney on your side, your appeal gains credibility—and teeth.

What If the Insurance Company Still Refuses to Pay?

If your insurer won’t budge, you may have to escalate to legal action.

File a Bad Faith Lawsuit

If the insurer’s denial was unreasonable or unfounded, you may have grounds to sue for bad faith. In these cases, you’re not just limited to recovering the original claim amount; you could also be eligible for additional damages such as emotional distress, attorney’s fees, and even punitive damages. 

A lawsuit sends a clear message that delay-and-deny tactics won’t go unchallenged.

Seek Mediation or Arbitration

When litigation isn’t the right first step, alternative dispute resolution options like mediation or arbitration may offer a quicker and less adversarial route. Mediation involves a neutral third party helping both sides reach a resolution, while arbitration can result in a binding decision. 

These paths can save time and money while still holding insurers accountable.

Let Daly & Black Build Your Case

If negotiations or appeals have failed, it’s time to bring in reinforcements. Daly & Black conducts a deep-dive investigation into your case. We subpoena internal communications, depose insurance adjusters, and uncover patterns of denial that may point to systemic bad faith. 

Our aggressive, strategic approach has led to the reversal of hundreds of denials across storm damage, life insurance, business interruption, and more.

Why Work with an Insurance Claim Denial Attorney?

Handling a denial on your own can be overwhelming—especially when insurers are armed with legal teams.

We Know the Playbook

Our attorneys have spent years going toe-to-toe with major insurance companies. We understand the tactics they use to justify denials—whether it’s invoking vague policy language, dragging out the investigation, or undervaluing your losses. This insight allows us to anticipate their moves and counter them strategically.

We Build Strong Claims

A successful appeal or legal action begins with airtight documentation and expert framing. We help clients gather and organize all supporting evidence, enlist the right experts, and construct arguments that force insurers to pay attention—and pay out.

We Maximize Payouts

Many insurers intentionally undervalue claims, offering settlements far below what you deserve. We don’t accept lowball offers. We pursue every avenue to ensure your damages are fully calculated—property loss, business interruption, emotional harm, and more.

No Upfront Fees

We believe everyone deserves strong legal representation, regardless of financial standing. That’s why we work on a contingency fee basis—you pay nothing unless we recover money on your behalf. It’s our way of going ALL IN for our clients.

FAQ

Why would an insurance company deny my claim? 

Common reasons include missed deadlines, insufficient documentation, exclusions in the policy, or disputed causes of damage. In some cases, insurers act in bad faith by delaying, underpaying, or denying claims unfairly.

Can I appeal a denied insurance claim, and how do I start?

Yes. Start by reading the denial letter, gathering supporting documents, and filing a formal appeal in writing. Appeals must usually be submitted within a set timeframe, often 30–60 days.

What are my options if the insurance company still refuses to pay?

If appeals fail, legal action may be necessary. A bad faith lawsuit can help you recover compensation, and sometimes more. Daly & Black is equipped to take your case all the way if needed.

Don’t Let a Denied Insurance Claim Derail Your Recovery

Insurance companies count on frustration and confusion to make you walk away. Don’t give them that power. If your claim has been denied, you still have options—and Daly & Black is ready to fight for you.Schedule your free consultation today. Daly & Black is ALL IN. ALL THE TIME.