Home Insurance Claims

What you need to know about home insurance claims

Dealing with home insurance claims can be tricky, like trying to solve an unfamiliar puzzle. When something in your house breaks or gets damaged, figuring out how to tell your insurance and get help can be tough. But don’t worry— we’re going to help simplify everything.

This article will explain the important stuff about home insurance claims in a way that’s easy to understand. Whether it’s your first time dealing with this or you’ve done it before, this guide is for everyone who wants to get a clear picture of how home insurance claims work.

What should I submit a home insurance claim for?

Figuring out when to file a home insurance claim can feel like a big decision. You want to make sure it’s worth it. Here’s a simple guide on when it’s a good idea to go ahead and file a claim and when you might want to handle things differently.

Here are some examples of when to submit a claim:

If there’s significant damage or theft

If something major happens to your home, like a fire or intense storm, or if someone breaks in and steals your stuff, it’s usually smart to file a claim. In these situations, the cost to fix or replace things is likely more than your deductible, and your insurance is meant to help with these problems.

If someone gets hurt

If someone gets hurt on your property, or if you accidentally damage someone else’s property, your insurance can cover the costs, like medical bills or legal fees. This can save you from having to pay a huge amount of money.

If your home is unlivable

If something so bad happens that you can’t stay in your house, and your insurance pays for you to stay somewhere else, filing a claim can help cover those living costs.

Here are some examples of when you might want to reconsider submitting a claim:

Minor repairs

If the damage is minor and the cost to fix it is about the same as your deductible, it might be better to just pay for it yourself. Filing a claim for small things can increase your insurance cost over time.

Frequent claims

If you’ve filed multiple claims in a short time, it could make your insurance more expensive, or it might be hard to get insurance later. Companies see this claims history as a sign that you might file more claims in the future, too.

Cosmetic damage

If the damage is only about looks and doesn’t actually make your house unsafe or unlivable, it’s probably not worth filing a claim. Insurance is there to help with the bigger things affecting your life. And if it’s just basic wear and tear, your insurance won’t cover it anyway.

Understanding your home insurance policy

Getting to know your home insurance policy is like learning the rules of a game. It shows you what help you can get when something goes wrong in your home. By understanding your home insurance coverage, you’re better prepared to handle claims and ensure you’re getting all the help your policy offers. Let’s break this down:

What’s covered

Your policy lists the problems it can help with, like fire, theft, or storm damage. But, if something happens that’s not on the list, you might not get assistance. For example, many policies help if a pipe bursts and causes water damage, but not if your house gets flooded due to a sewer backup.

Limits and deductibles

Every policy has a maximum amount they will pay (this is your limit). If fixing your home costs more than this, you will have to pay the difference.

A deductible is what you pay before your insurance starts to help. Knowing these amounts tells you how much you might have to pay by yourself.

Replacement cost vs. actual cash value

Insurance can pay you in two ways: either they give you enough money to buy a new item (replacement cost) or the amount your old item is worth today (actual cash value), which is usually less because things lose value over time. Knowing which one your policy uses is important for understanding how much money you can get.

Liability coverage

This part of your policy helps if someone gets hurt on your property or if you accidentally property damage someone else’s personal property. It can help pay for legal fees, medical bills, and more, so it’s good to know how much protection you have.

Additional living expenses

If your house is so damaged that you can’t stay there, your policy might pay for you to live somewhere else temporarily, like in a hotel or a rental. Knowing about this can help you plan and save money if you ever need to use it.

The fine print

Policies also have rules about what they don’t cover and what you need to do when you file a claim. Knowing these rules can help you avoid surprises later.

Make sure you check your policy often

Your life and home change over time, so it’s good to check your policy now and then to ensure it still fits your needs. Maybe you’ve upgraded your kitchen or bought something valuable that needs to be added to your policy.

How to file a home insurance claim

Filing a home insurance claim can seem tough, but this easy guide can help you through the entire claims process:

Step 1: Check your policy

First up, look at your insurance policy quickly. This helps you see if the damage is something your insurance will help with. Knowing what’s covered, your coverage limit and your deductible is essential here.

Step 2: Take pictures of the damage

Think of it like taking photos or videos to remember something important, but this time, it’s for the damage. This shows your insurance company exactly what went wrong and how serious it is. If you have receipts or a list of the damaged items, get those ready, too. They help prove the value of what you lost or what got damaged.

Step 3: Protect your home from more damage

If something bad happens, you may need to do a little bit to stop more damage from happening. For example, if a window broke, you’d cover it up to keep rain out. But wait for the bigger fixes until your insurance says it’s okay because they’ll want to check out the damage first.

Step 4: Call your insurance company

Now’s the time to reach out to your insurance company. You can call them, go online, or use an app if they have one. Let them know what happened and start the claim process. They’ll give you a claim number to keep track of your case.

Step 5: Fill out the forms they send you

Your insurance will send some forms to fill out, asking about the damage and what happened. Fill these in as best and as fully as you can. If you’re stuck on something, asking them questions is fine.

Step 6: Meet with the claims adjuster

An insurance/claims adjuster will likely come by to look at the damage themselves. They check everything out to decide how much money the insurance should give for repairs. Have your photos and documents ready to show them.

Step 7: Get quotes for the repairs

While waiting for the adjuster, you can start getting quotes from repair companies to know how much fixing everything might cost. But don’t start fixing anything big until your insurance gives you the green light.

Step 8: Review the insurance’s offer

After the adjuster sees the damage, your insurance will make you an offer to fix things. Check this offer carefully to make sure it’s enough to cover your repairs. You can talk to them about it if it’s too low, using your pictures and repair quotes as proof.

Step 9: Fix your home and finish the claim

Once you and your insurance agree on the amount, you can proceed with the repairs. After everything is fixed and paid for, your claim is finished. Keep all your paperwork and receipts related to the claim, just in case you need them later.

What to do if your claim is denied

Getting a home insurance claim denied can feel like hitting a wall, but it’s not the end of the road. While it is certainly frustrating, by taking the following steps, you can either overturn the decision or understand more clearly why it was made.

Find out why it was denied

The first thing to do is understand why your insurance company said no to your claim. They should tell you the reason in writing. Common reasons might be that your policy doesn’t cover the damage, the cost is less than your deductible, or you waited too long to file the claim. Knowing the exact reason is key to figuring out what to do next.

Check your policy again

After you know why your claim was denied, look at your insurance policy again. Focus on the parts that are related to your claim. This can help you see if there was a mistake or if there’s a chance you could challenge the denial.

Collect more proof

Sometimes, claims are denied because there wasn’t enough proof of the damage or the insurance company didn’t get the necessary information. If you think this happened to you, try to get more evidence or extra information to support your claim. This could be more pictures, repair quotes, or expert opinions.

Appeal the denial

If you think the denial was unfair, you can ask the insurance company to take another look. Find out how their appeal process works. You’ll usually need to write a letter explaining why you think your claim should be approved, including any new evidence you have. Make sure to point out specific parts of your policy to back up your argument.

Get help if you need it

Dealing with appeals can be tricky. If you’re feeling overwhelmed, you might want to get some help. A public adjuster can look at the damage and talk to the insurance company for you. If things are serious, talking to a lawyer who knows much about insurance could also be a good idea. They can advise and help you if you decide to take further steps.

Legal action

Taking legal action is a big step and should be considered carefully. It might be necessary if your claim is for a lot of money and you truly believe the denial was wrong. Talk to a lawyer to understand your chances and what’s involved. This path can take a lot of time and money, but sometimes, it’s the only way to get what you’re owed.

Frequently asked questions

Is it worth claiming on home insurance?

It depends on the situation. If the cost to fix or replace something is much more than your deductible, it’s probably worth it. But if the damage is small and the cost is close to your deductible, it might be better to pay for it yourself to avoid higher insurance costs later.

How long do I have to make a home insurance claim in Ontario?

In Ontario, you usually have up to one year from the date of the damage to file a home insurance claim. But it’s a good idea to check your policy or talk to your insurance company as soon as possible to make sure.

How long does an insurance company have to investigate a claim in Canada?

In Canada, insurance companies usually have to start investigating your claim within a certain timeframe after you report it, often 10 days. The total time to finish investigating can vary based on the complexity of the claim, but they should keep you updated on the progress.

What is an example of an insurance claim?

An example of an insurance claim is if a tree falls on your house during a storm and causes damage to your roof. You would file a claim with your home insurance company to cover the repair costs for the roof.