Steps To Take If Your Flood Insurance Claim Is Denied

Most homeowners’ insurance policies do not cover flood damage. For that reason, many people who live in areas prone to flooding purchase separate flood insurance. That coverage is often provided through the National Flood Insurance Program (NFIP), though some private insurers also offer flood policies.

Even with coverage in place, flood claims do not always go smoothly. After submitting a claim, some policyholders receive a denial letter or a decision stating that only part of the loss will be covered. That can be frustrating, particularly when the property damage is obvious.

A denial does not necessarily end the process. In many cases, the insurer’s decision can still be reviewed or challenged. The next steps depend on why the claim was denied in the first place.

This article looks at common reasons flood insurance claims are denied and what policyholders can do when that happens, including hiring a flood damage lawyer.

Why do flood insurance claim denials happen?

Flood insurance claims are sometimes denied because the insurer believes the damage was not caused by flooding as the policy defines it.

Flood policies are very specific about what qualifies as a “flood.” Water entering a building because of rising surface water may qualify, while water caused by plumbing failures, groundwater seepage, or drainage issues may not. When adjusters inspect a property, they often look for physical signs that help determine how the water entered the structure.

Disagreements can start there. For example, an insurer may conclude that water entered through the foundation rather than from rising floodwaters. A homeowner may see the same damage and assume the flood was clearly responsible.

Other denials happen because of procedural requirements built into the policy. Flood policies usually require policyholders to submit documentation within strict timelines. For NFIP policies, policyholders must generally submit a signed and sworn Proof of Loss statement within 60 days of the date of loss (although FEMA may extend that deadline following major disasters).

There are also situations where the dispute centers on how the insurer evaluated the damage. An adjuster may decide that certain repairs relate to pre-existing issues or maintenance problems rather than flood damage. In other cases, the insurer may determine that some parts of the property are not covered under the policy.

When a claim is denied, the explanation in the denial letter usually points to one of these issues.

What can you do in the aftermath of a flood insurance claim denial?

A denial letter can feel final, but it usually is not the last step. Flood insurance policies often include procedures for requesting reconsideration or submitting additional documentation.

The right response depends on the reason given for the denial.

Review your policy and gather evidence to support your claim

The first thing many policyholders do is read the denial letter carefully and compare it to the policy itself. The insurer should identify the provision it relied on when denying the claim.

Sometimes the issue turns out to be narrower than it first appears. A denial may apply only to a specific portion of the damage rather than the entire claim.

Once the reason for the denial is clear, it often makes sense to gather additional documentation. Photographs, repair estimates, contractor reports, and receipts can help illustrate the scope of the damage.

For example, photographs taken shortly after the flooding may show water lines on walls or flooring that was saturated by standing water. Those kinds of details sometimes become important when the insurer reviews the claim again.

Policyholders can also contact the insurer to confirm how the appeal process works and what materials must be submitted for reconsideration.

Prepare your appeal letter

Flood claim appeals are usually submitted in writing. The appeal letter typically explains why the policyholder believes the denial was incorrect and includes any supporting documentation.

This is where the details matter. The appeal should respond directly to the insurer’s explanation for the denial. If the insurer claims the damage was not caused by flooding, the appeal may focus on evidence showing how the floodwaters entered the property.

Contractor reports, photographs, and inspection notes are often included with the appeal. Sometimes additional documentation changes the insurer’s view of the claim.

Consider contacting your state’s insurance regulator

Policyholders may also consider contacting the state agency responsible for regulating insurance companies. Most states have a department of insurance that accepts consumer complaints and can sometimes help facilitate communication with an insurer.

For private flood insurance policies, these agencies may review the complaint and request information from the insurer about how the claim was handled.

Claims under the National Flood Insurance Program (NFIP) operate differently because they are governed by federal rules administered by FEMA. Disputes involving NFIP claims may instead require using FEMA’s appeal process or other remedies provided under federal law.

In some situations, a regulatory inquiry can prompt additional review of the claim or help clarify the insurer’s position.

Consider hiring a flood insurance lawyer

Some disputes become difficult to resolve through the insurer’s internal process alone. When that happens, policyholders sometimes seek legal advice about the claim.

There is no single point when a lawyer must become involved. Some policyholders consult an attorney early to review the policy and documentation. Others seek legal help only after an appeal has already been denied.

Legal review often focuses on the same questions that started the dispute: how the policy defines a covered flood, how the insurer evaluated the damage, and whether the claim investigation followed the policy requirements.

If your claim is through the NFIP, you must file a lawsuit in federal court within one year of the written denial of all or part of the claim. Note that filing a FEMA appeal does not extend this one-year deadline.

Do you need help with a denied flood insurance policy claim?

Flood claims can involve complicated policy provisions and strict documentation requirements. When a home or business has been damaged, working through the claims process while arranging repairs can be difficult.

McWherter Scott & Bobbitt’s experienced property damage lawyers represent policyholders in property insurance disputes, including claims involving flood damage and other natural disasters. Our work typically involves reviewing the policy, examining the claim file, and evaluating how the insurer handled the claim.

That review may include examining repair estimates, evaluating coverage provisions, or working with professionals who help assess property damage.

Call or fill out our online contact form to schedule a consultation with the attorneys at McWherter Scott & Bobbitt.