Your Claim Was Denied. That Doesn't Mean It's Over.
Insurance carriers deny claims every day. Sometimes they're wrong. We know how to prove it — with building codes, manufacturer specs, and the policy language they hoped you wouldn't read.
About This Service
Understanding Denied Insurance Claims
A denial letter can feel final, but it's not. Carriers deny claims for dozens of reasons — missed deadlines, disputed cause of loss, "insufficient documentation," wear and tear, cosmetic damage only. Some of those reasons are legitimate. Many aren't. Our job is to figure out which one yours is and build the case to overturn it. Under Louisiana law (La. R.S. 22:1892), your carrier has 60 days to pay a residential property claim after receiving satisfactory proof of loss. If they blow past that deadline or deny your claim without a valid reason, they may owe you penalties — up to 50% of the unpaid amount plus attorney's fees. But penalties don't collect themselves. You need someone who can document what the carrier missed, cite the codes that require the repair, and put together a demand they can't brush off.
Our Approach
How We Handle This Differently
Most public adjusters resubmit the same paperwork with a cover letter. We go deeper. We inspect the property ourselves — roof to foundation — and document damage the carrier's adjuster missed or ignored. Every line item in our Xactimate estimate has a building code citation or manufacturer spec behind it. IRC sections, local amendments, manufacturer installation requirements — that's what turns a "we disagree" into a demand the carrier has to take seriously. We also review your actual policy language, not just the denial letter. Carriers sometimes cite exclusions that don't apply to the specific loss, or they misread their own policy provisions. We've seen denials overturned just by pointing the carrier to the right page of their own policy. And because Louisiana law (La. R.S. 22:1703) requires public adjusters to charge flat or hourly rates — not contingency fees — we're not incentivized to drag out your claim or inflate numbers. We charge a fair rate for honest work.
Carrier Tactics
When Your Carrier Pushes Back
"Pre-existing damage"
This is the most common denial tactic, especially on older roofs. We document the damage timeline with photos, weather data, and manufacturer specs to prove the damage pattern is consistent with the claimed event — not wear and tear. There's a real difference between a 15-year-old roof that's aging and one that took hail. We know the difference because we've been on thousands of roofs.
"Not covered under your policy"
We pull the actual policy language and show where the coverage applies. Carriers sometimes cite exclusions that don't apply to the specific loss, or they misread their own provisions. We've overturned denials just by pointing the adjuster to the right section of the policy.
"Insufficient documentation"
We provide comprehensive documentation — measurements, code references, manufacturer installation specs, and damage photos that meet adjuster standards. When a carrier says "insufficient documentation," what they usually mean is "nobody showed us why we have to pay." We show them.
"Wear and tear / deterioration"
Carriers admit there was a storm but say the damage is normal aging. This is the #1 tactic on older roofs. Our construction background means we can distinguish storm damage patterns from normal deterioration — and we document the difference with manufacturer specs that define what damage looks like versus aging.
"Cosmetic damage only"
Carriers call impact damage "cosmetic" to avoid paying for replacement. But cosmetic damage on a roof can compromise the material's service life and weatherproofing integrity. We cite manufacturer warranty requirements and building codes that define when cosmetic damage requires replacement.
"Late notice of loss"
Some carriers deny claims because you reported damage months after the storm instead of days. Louisiana law doesn't set a hard deadline for notice — your policy does. And "prompt" doesn't mean "immediate." We've successfully reopened claims that carriers tried to kill on late notice by documenting when the damage was reasonably discoverable.
"That's flood damage, not wind"
After hurricanes, carriers invoke anti-concurrent causation clauses to blame everything on flooding — even when wind clearly caused damage before any water arrived. We separate wind damage from flood damage with field documentation, elevation analysis, and weather timeline data. The burden is on you to prove what the covered peril caused, and that's exactly where construction expertise matters.
"Failure to mitigate"
You have a duty to prevent further damage after a loss — tarping a roof, boarding windows. But carriers sometimes use this to deny the entire claim when you were late getting a tarp up. The duty to mitigate doesn't erase the duty to pay for covered damage. We document your mitigation efforts and argue proportionality.
Common Questions
Frequently Asked Questions
Can a denied insurance claim really be overturned in Louisiana?
Yes. Denials are overturned regularly when the policyholder provides proper documentation and code-backed arguments. The carrier's first answer isn't always the right one. We review the denial, inspect the property, and build a documented case for reconsideration. If the carrier still won't budge, we can help you pursue the appraisal process or refer you to an attorney for legal action.
How long does an insurance company have to pay a claim in Louisiana?
Under Louisiana law (La. R.S. 22:1892), your insurance company must begin adjusting your claim within 14 days of receiving notice of loss. For residential property, they must pay undisputed amounts within 60 days of receiving satisfactory proof of loss. If they miss these deadlines without a legitimate reason, they may owe you a penalty of 50% of the unpaid amount plus attorney's fees.
What does a public adjuster charge in Louisiana?
Louisiana is the only state that prohibits public adjusters from charging contingency fees (La. R.S. 22:1703). We charge flat or hourly rates, which means we're not incentivized to inflate your claim or drag out the process. We discuss fees upfront during your free consultation — no surprises.
How long do I have to dispute a denied claim in Louisiana?
Most Louisiana homeowners policies contain a two-year suit limitation clause, meaning you have two years from the date of loss to file a lawsuit if the carrier won't pay. This deadline is hard — missing it means you lose your right to challenge the denial in court. Don't wait to get help.
What is bad faith insurance denial in Louisiana?
Bad faith occurs when an insurance company arbitrarily denies or underpays a claim, misrepresents policy provisions, or fails to pay within the statutory deadlines without a legitimate dispute. Under Louisiana law, if your carrier acts in bad faith, you may be entitled to a penalty of 50% of the amount owed plus attorney's fees. As of 2024, the law requires a 60-day written cure notice before filing a bad faith lawsuit.
What is the difference between a public adjuster and a lawyer?
A public adjuster inspects damage, writes estimates, and negotiates with the carrier on your behalf to settle the claim. An attorney handles legal disputes — lawsuits, bad faith claims, breach of contract actions. We handle the claims process. If your claim needs legal action, we refer you to an attorney. Many denied claims are resolved through the claims process without ever needing a lawyer.
Can a public adjuster reopen a denied claim?
Yes. We review the denial reason, inspect the property, and submit a new demand with documentation the carrier hasn't seen — building code citations, manufacturer specs, detailed photos, and a complete Xactimate estimate. This isn't just resubmitting the same paperwork. It's building a new case with evidence the carrier can't ignore.
Should I file a complaint with the Louisiana Department of Insurance?
You can and you should — it creates a paper trail. File online at ldi.la.gov or call 1-800-259-5300. The LDI will investigate and can enforce Louisiana insurance laws. But the LDI can't force your carrier to pay or settle your claim. That's where a public adjuster comes in — we handle the documentation and negotiation that actually gets claims resolved.
My carrier says my roof damage is just wear and tear. Are they right?
Maybe, but probably not if there was a recent storm event in your area. There's a real difference between aging and storm damage, and it takes someone with roofing experience to tell them apart. Hail creates specific impact patterns. Wind lifts and creases shingles in ways that aging doesn't. We inspect the roof, identify the damage patterns, and document the difference with manufacturer specs.
What is an anti-concurrent causation clause?
An anti-concurrent causation (ACC) clause says that if a covered peril (wind) and an excluded peril (flood) both contribute to damage, the carrier can deny the entire claim. This comes up constantly in Louisiana after hurricanes. The key is separating what the wind did from what the water did — and documenting it before anyone cleans up. Our construction background lets us trace damage to its source.
Is it worth hiring a public adjuster for a denied claim?
If your claim was denied and you believe the damage is covered, yes. Most homeowners don't have the documentation, code knowledge, or estimating tools to challenge a denial effectively. We bring Xactimate, building code references, and field experience that turns a "no" into a documented demand. We charge a flat fee — so you know the cost before you commit.
How long does it take to fight a denied claim?
It depends on the carrier and the complexity of the claim. Simple reconsiderations can take 30-60 days. Claims that go to appraisal take longer. We move fast on our end — the timeline is usually determined by how quickly the carrier responds. Louisiana law gives carriers 60 days to pay after proof of loss, and penalties start if they miss that window.
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