Can You Be Denied a Home Insurance Claim?
What every homeowner should know about why claims are refused and how to avoid it
Home insurance is there to help you recover after a fire, storm, or break-in. But having a policy doesn’t mean every claim is guaranteed to be approved. There are specific reasons why insurers deny claims, and knowing these can save you time, money, and frustration. This becomes especially important when you're preparing to file a claim, or evaluating whether your current coverage actually matches your risks.
Common Reasons Claims Are Denied
Rather than listing every possible scenario, insurers tend to deny claims for a few consistent reasons:
1. Poor Maintenance or Neglect
Insurance protects against sudden, accidental damage, not wear and tear. A slow leak, a rotting roof, or pest infestation that develops over time may be considered homeowner responsibility.
2. Damage from an Excluded Risk
Not everything is covered by default. Events like overland flooding, sewer backup, or earthquake damage typically require separate endorsements.
3. Misrepresentation or Missing Information
If you forgot to disclose that you rent out your basement, or that you run a home business, the insurer may refuse to pay for related claims.
4. Your Policy Wasn’t Active
If a payment was missed and the policy lapsed, even by accident, the claim may be denied based on lack of coverage at the time of the incident.
5. The Cause Doesn’t Match Your Coverage
Insurers only pay when a listed cause of damage—fire, theft, wind, etc.—is proven to have occurred. Claims with vague or disputed causes may be refused.
What You Can Do to Protect Yourself
Rather than wait until you’re in the middle of a stressful claim process, take these simple but powerful steps in advance: Review your policy yearly. Ask your insurer to walk you through your current coverage and point out common exclusions. Keep up with home maintenance. A well-kept home is less likely to suffer damage, and easier to defend during a claim. Document everything. Before and after damage, take photos and keep receipts for repairs or upgrades. Report changes. Any renovation, rental, or major lifestyle change that affects the home should be disclosed.
| Potential Issue | Impact on Claim |
|---|---|
| Water damage from aging pipes | Often denied due to wear, not sudden event |
| Unreported rental suite | May void liability or dwelling-related claims |
| Missed premium payment | No coverage during lapse |
| Undisclosed home business | Personal policy may not cover business-related loss |
If You’re Denied, What Next?
A denied claim isn’t always final. If you believe it was denied in error: Ask for a written explanation and review the reasons. Gather new documents, photos, or expert opinions. Request an internal review from your insurer. Contact your province’s insurance ombudsman for help.
Tip: Never rely on assumptions. What feels like an obvious loss to you may be considered avoidable or excluded by your policy language.
Prevention Is Your Strongest Protection
The best time to think about claim denial is before it ever happens. By understanding your policy, staying honest and proactive with your insurer, and documenting your home’s condition, you’ll put yourself in the best position for a smooth, successful claim when it really counts.