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Your insurance claim was denied or underpaid. What now.
A letter arrived saying no, or saying a number far below what the repair costs. Here is what that letter has to tell you, what to gather, and how to prepare a documented response.
Start with the reason given for the decision and any policy language the letter cites. Ask for a written explanation if the basis is unclear.
That is the thread you pull. A denial that cites a specific exclusion can be checked against the policy language and against what actually happened. A denial that says something vague about the cause of loss is a different problem — and both are answered the same way, with documents rather than argument.
What to gather, in this order
The five things every one of these turns on
- The policy itself — the full one, declarations page and all, not the summary in the app. Ask the carrier in writing for a certified copy if you do not have it.
- The denial or underpayment letter, and every letter or email before it.
- Proof of what the loss actually cost — a contractor's estimate, invoices, receipts.
- Photographs of the damage, as many as you have, from as early as you have them.
- A dated record of the claim — when you reported it, who you spoke to, what they said, when the adjuster came.
Deadlines exist here too, and they are quieter
A policy usually sets its own time limits: how long you have to report a loss, how long to submit a sworn proof of loss when the carrier asks for one, and how long you have to bring suit — often shorter than the general limit for a contract claim in your state. Those clocks run whether or not anyone reminds you, and notice obligations vary by state and circumstances.
Read the policy's own conditions section for them, and confirm anything you are unsure about with your state's department of insurance, which exists for exactly this and costs nothing to call.
What a carrier actually responds to
Not indignation. A number, itemized, with the documents behind it.
- A line-item estimate rather than a total
- "The roof is worth $28,000" invites a counter. A scope broken into line items with quantities and price sources makes the disagreement easier to identify. It does not guarantee that the insurer will accept those items.
- The policy language they relied on, addressed directly
- If they cited an exclusion, the answer names it and explains from the documents why it does not fit what happened.
- Photographs tied to specific damage
- Not a gallery. Each picture attached to the line item it supports.
- A record of their own conduct
- When you reported it, how long they took, what they said each time. Delay and shifting reasons are their own issue, separate from the money.
Where the software comes in
PAi Claims takes the photographs and the paperwork and builds the estimate and the demand letter around them, with line items and regional pricing, to help you prepare a documented submission for review.
The first claim costs $20. A public adjuster takes a percentage of the settlement, and a contingency-fee lawyer takes more — which is the right choice for some claims and an expensive one for a claim you could have documented yourself.
If it goes further than a letter, the same record moves into PAi Legal, which handles the litigation side and treats every fact as unproved until it is sourced in that matter's own file.
Nothing here is a promise about your claim. The software organizes and prices what you have; it does not know what your policy says until you put the policy in, and it will tell you plainly when something you are claiming has nothing behind it.
Your state's department of insurance takes complaints about carrier conduct, free, and a licensed lawyer in your state can tell you what applies to you. Both are worth more when you arrive with an organized file.