LegalReader.com  ·  Legal News, Analysis, & Commentary

Business

What are the Main Reasons for Home Insurance Claims Denials in New Mexico?


— April 14, 2022

If you make a water damage claim, the insurer might deny your claim arguing that the damages were caused by seepage, which is not covered.


If you have a mortgage in the state of New Mexico, then the lender will insist you get mandatory home insurance. Some homeowners go out of their way and get a comprehensive all-risk insurance policy thinking they will be covered no matter what. It’s all risk, it says so in its name, right? Well, no, when you make a claim you may be shocked to hear that the damage you specify is not actually covered as it falls under the many exclusions insurers have in their well-crafted policy. When your claim is unjustly denied or delayed beyond reasonable limits, the only way to get the damages you’re entitled to is to look up the best New Mexico homeowners insurance claim denial lawyers you can find. 

Main reasons homeowners insurance claims are denied

Insurers are extremely creative when it comes to finding reasons to deny your claim or to minimize the amount of damages you’re entitled to. They use all sorts of pretexts and you’ll need a highly-skilled lawyer to understand whether their reasons would stand in court or they’re just trying to intimidate you with confusing legal terms. 

The infamous wear and tear exclusion

This is one of the most common reasons cited by insurers when they deny your claim. No matter what type of home insurance claim you make, their well-paid insurance adjusters will conclude that the damages were not caused by wind or flooding, but by normal wear and tear, which is not covered under standard or all-risk policies.

If, for instance, a storm damages the roof, their adjusters might claim that it was not the wind, but the fact that the shingles on the roof had not been replaced in ages or they had been improperly installed in the first place.

Failure of asphalt shingles allowing roof leakage; image by Dale Mahalko, CC BY-SA 3.0, via wikimedia.org, no changes.
Failure of asphalt shingles allowing roof leakage; image by Dale Mahalko, CC BY-SA 3.0, via wikimedia.org, no changes.

Homeowners do have the duty to maintain their property in good shape and carry out repairs when needed, but this wear and tear exclusion is extremely versatile and can be used to deny a wide range of damages. 

However, if you contact a knowledgeable homeowners insurance claim denial attorney in Albuquerque, they can help you disprove their claims by bringing in independent adjusters to make an honest appraisal of the situation.

Not insured risks

If you think your claim was wrongfully denied you should schedule a free consultation with an insurance claims lawyer and have them go over the documents. You need someone who can translate in plain English the very confusing language used in an insurance policy to understand exactly what sort of perils are covered. For example, if you make a water damage claim, the insurer might deny your claim arguing that the damages were caused by seepage, which is not covered, and not by the burst pipe in the basement. 

Should I sue the insurance company?

That is for your lawyer to decide and it’s usually a last recourse measure. An attorney with many years of practice in this area of the law will build a solid appeal case and present it to the insurance company. This puts the insurer in a tight spot. If your lawyer makes a convincing case, the insurance company will prefer to settle out of court rather than go to trial and risk being order to pay punitive damages on top of what they already owe you.

Join the conversation!