Why Claims Fail
Your carrier has a team
reading your claim.
Now you do too.
Most insurance claims pay less than they should — not because the loss wasn't covered, but because policyholders don't know the rules carriers play by. ClaimSplain does.
1 in 8
homeowner claims result in a full or partial denial
Source: Insurance Information Institute
68%
of policyholders don't dispute their settlement offer
Source: United Policyholders research
60 days
typical proof of loss deadline — most policyholders miss it
Source: Standard policy conditions
$41B+
in property insurance claims paid annually in the US
Source: NAIC 2024 data
These practices are legal and common — but rarely disclosed.
Adjusters Work for the Carrier — Not You
The adjuster works within the carrier's guidelines — not to maximize your recovery.
ACV vs. Replacement Cost — The Gap Nobody Explains
Settlements often pay depreciated cash value; if you don't claim the replacement-cost holdback, you forfeit thousands.
Proof of Loss Deadlines Are Strictly Enforced
A sworn proof of loss is usually due within 60 days — missing it can void your right to dispute.
Scope Disputes Are the Most Common Underpayment
Estimates routinely exclude line items, use below-market rates, or omit code upgrades — carriers rely on you not knowing.
Denial Letters Are Written by Attorneys
Denials cite exclusions in precise legal language; many are disputable if you understand what the letter says.
Delay Is a Strategy
Long timelines favor the carrier — you deplete savings and accept less; knowing your deadlines is your defense.
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