The insurance company doesn't pay after the appraisal?! – We at Deutsche Schadenhilfe know a lot of such cases. Whether household contents insurance or building insurance: there are often problems and delays in the settlement of claims. – We support you with an expert network of experts and specialist lawyers for insurance law.
Insurance does not pay after expert opinion - what to do? Who helps?
If there is water damage in the apartment or in the house, the trouble is of course great - if you also have problems with the insurance, the chaos becomes perfect. Unfortunately, it often happens that insurance companies refuse to pay after an expert opinion and do not want to take over the damage. The insured then understandably reacts in shock, since he does not want to pay for the damage himself – or even cannot.
The problem with this is that the insurance companies often do not refuse a payment out of bad faith, but simply because the contracted tariff does not provide for a payment for the risk that has occurred. This can lead to nasty surprises, especially for laypeople who are often unfamiliar with insurance and therefore disregard important elements when concluding the contract. Nevertheless, there are also solutions for problems with the insurance regarding the payment - and often even many possibilities to still receive compensation - as we know from experience at Deutsche Schadenhilfe. We support insured persons in problematic cases of damage - with experts, specialist lawyers and our own network of experienced rehabilitation service providers - we present everything important on the subject below. – If you need support, please feel free to contact us.
Building insurance does not want to pay after water damage: What's next?
If building insurance does not want to pay for water damage (see building insurance does not pay ), the problem is often that this is what is known as elementary damage. Unfortunately, these are not covered by many insurance companies. This is often felt by homeowners who are insured against storms or damage to the mains water , but not against flooding caused by heavy rain or high water. The insurer only pays for such damage if you take out natural hazard insurance or choose natural hazard protection in addition to building insurance (see building insurance scope of benefits ).
It is important to know that such protection against natural hazards can no longer be booked once the damage has already occurred. In this case, you are usually on your own at first - however, a professional report can still provide a remedy and ensure that the costs for a renovation are still borne by the insurer. Because the cause of the damage is not always what the insurer or an appraiser working for the insurance company has determined (see contest insurance appraisal , contest expert appraisal ). In addition, a professional, independent appraisal sometimes turns out to be another, true reason for damage.
An example: If a balcony has become full of water due to heavy rainfall and this has led to serious damage to the masonry of the building, the building insurance will perhaps respond with the answer that damage due to heavy rain will not be paid (cf. Allianz residential building insurance does not pay ). This does not mean, however, that the insured person is left with the costs, because it can often be proven that there were construction errors during the construction of the house (see construction errors house construction) - such as inadequate water drainage through rain and gutters. Here the construction company could then be held responsible for taking over the damage and renovating the balcony. It is not uncommon for such reports to be drawn up by an independent expert because the insurance companies do not look too closely, want to put the case aside quickly and refuse to assume the costs directly. So it is worthwhile for the injured party to take the time to properly examine the guilt and the cause. – You want to find the right expert ? – Deutsche Schadenhilfe would be happy to support you with a professional report / counter-report by certified experts.
Household contents insurance does not want to pay after expert opinion - important tips for insured persons
There is also often the problem: " Household contents insurance does not pay according to expert reports " - but how can that be if the inventory ( household goods) should be insured in the event of damage? A good example here is the balcony flooded with water, where the water pushes through the door and into the house, where it causes damage to the furniture. Here, too, it can happen that the household contents insurance does not pay out according to the expert opinion because it is a matter of "natural damage" that is not insured. – But even in this case, the injured party does not necessarily have to bear their costs, which can often only be determined by an independent expert. If the cause is, for example, that the gutter was not cleaned correctly and the water drains were blocked as a result, the landlord or homeowner is responsible for this. He then has to bear the costs for repairing the damage ( water damage repair) take over. The situation is different, of course, if you own the house yourself, then you have to pay for the damage out of your own pocket.
Both cases show that by determining the cause very precisely , it is often not possible to judge at first glance until the right reason for the damage has been found. A case such as "insurance does not pay despite an expert's report" or "insurance company refuses to assume costs despite an expert's report" can often end well for the insured. See also: Water Damage - Insurance Doesn't Pay.
Insurance does not pay despite expert opinions or does not adhere to it: What the insured have to do
The cases mentioned above show that it can often happen that an insurance company sends an appraiser but simply refuses to assume the costs because a certain risk is not insured. However, if you investigate more closely why the damage could have happened in the first place, completely different reasons often emerge. For this reason, insured persons should not simply settle for the result that “insurance does not pay according to the expert opinion”, but call in an independent expert who can take a look at what is happening again on site.
For laypeople, reasons other than what is said by the insurance company are often difficult to recognize - nevertheless, in many cases it is worthwhile for an expert to take a closer look. And especially when it comes to damage that costs several thousand euros to repair, it pays off to object to the expert opinion and invest in an expert who will finally check the facts again - usually this check is not the case at all expensive.
Insurance does not want to pay despite expert opinions or delays payment: how insured persons can put pressure on them
If the insurance company determines after an expert opinion that it is obliged to pay and replaces damaged objects or assumes the renovation costs, but nevertheless delays the payment, insured persons do not have to sit still and wait for the insurer to react. In principle, it is of course quite normal for insurance companies to take a few days or a few weeks to finally examine a situation: an expert has to be dispatched, and it often takes a lot of time to review the documents submitted by the insured person. You often have to wait a long time before you get a message.
But what if the insured has already announced that he will pay for the damage but is delaying the payment – by several months? This is precisely a massive problem for many insured persons, since renovations are of course not cheap (cf. Hamburg water damage restoration ) and they may have to pay in advance. There is no question that this quickly tears a big hole in the wallet of an average earner. With insurance companies, however, there is often not just a single case on the table, but a whole stack that only a few clerks have to process internally. Nevertheless, no insured person can be expected to wait for an excessively long time, because after all, they also pay a certain amount for their policy - and that every month or year.
It is therefore extremely important for the insured to try to settle claims quickly themselves. If the insurer does not react even after several weeks and does not want to pay after the report, the insured should remain persistent and contact them directly by telephone or in writing. It is also legitimate to set the insurer a specific deadline within which the claim should be settled. If nothing happens and the insurer delays the payment or does not calculate according to an expert opinion, it is advisable to contact a lawyer. He can check the facts again and put pressure on the insurance company - at the latest then you will be successful in most cases.
We would be happy to put you in touch with an experienced and competent specialist lawyer for your problem. Deutsche Schadenhilfe manages a corresponding network of professional lawyers for insurance law and can put you in touch with them.
Conclusion: insurance does not pay according to the report? – Being active is worth it!
Unfortunately, the problem of “insurance not accounting according to expert opinion” or “reducing claims” is a frequent one, which can lead to conflicts and legal disputes again and again. Sometimes the claims of the injured party can really only be enforced in court. It is therefore important for insured persons in such a case to contact an expert who works independently - this is the only way to obtain a well-founded and legally valid report. If the insurer has already agreed to a payment but is still delaying it, you have to take action yourself so that something happens. If necessary, this can also be done with the support of a lawyer if nothing has happened after repeated inquiries. Of course, a lawyer has his costs and so does a court case. However, if you as the injured party / policyholder are right, the insurance company usually has to cover these costs - in addition to your claims for repair and rehabilitation services.
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