Your claim was denied. Now what?
If you’re holding a denial letter, the most important thing to know is this: a denial is the beginning of the dispute, not the end of the claim. Carriers deny claims they later pay all the time. The letter is the carrier’s position — reasoned in some cases, reflexive in many others — and Arizona law gives you the right to test it. What you do in the weeks after a denial matters more than almost anything else in the life of the claim.
WJ Gould Law represents Arizona homeowners and small businesses against insurance carriers in first-party property claims. That is the entire practice. We read denial letters for a living, and we know which ones are defensible and which ones fold under documentation the carrier hoped you wouldn’t produce.
Five signs your denial is worth a second look
- The denial cites a vague exclusion — “wear and tear,” “pre-existing,” “wind-driven rain,” “gradual,” or similar — without explaining why the actual covered event didn’t cause the loss.
- The carrier’s estimate is more than 20% below an independent licensed contractor’s written estimate for the same scope.
- The carrier has been “reviewing” the claim for 60+ days without movement, and calls or emails go unanswered.
- The carrier requested an Examination Under Oath (EUO) — a formal, recorded proceeding you should not walk into without counsel.
- The denial cites weather or hail-strike data showing “no event” on your date of loss — but you have storm photos, contractor reports, or neighbor accounts that say otherwise.
If any of these describe your situation, the denial deserves a real review before you accept it.
Why carriers deny — and how those denials get reversed
Most denials rest on one of a handful of arguments: late notice, a stretched exclusion, disputed causation, or “insufficient documentation.” Each is a factual position, and each can be met:
- Late notice. Arizona carriers lean on notice provisions hard, but late notice generally has to prejudice the carrier to justify a denial. We develop the timeline and the reason for any delay.
- Stretched exclusions. “Wear and tear” and “pre-existing” are conclusions, not proof. Independent inspections and engineering reports frequently show the covered event — the hailstorm, the microburst, the pipe rupture — caused the loss.
- Disputed causation. This is a battle of experts, and carriers count on homeowners not having any. We bring the contractors, engineers, and weather data that carriers hope you can’t afford.
- Documentation. What the carrier calls a documentation failure is often just a claim that was never developed. We build the file the way it should have been built the first time.
What happens after you send us your denial letter
- We review the denial letter, your policy declarations, and your loss documentation. Free.
- Within 48 hours we call you with a straight read — is the denial defensible, what facts did the carrier miss, and what does the path forward look like?
- If we take the case, you sign a contingency-fee agreement. No fee unless we recover.
- We move the file. The carrier hears from us directly. You stop being the one in the middle.
When a denial crosses into bad faith
Arizona recognizes a duty of good faith and fair dealing in every insurance contract. A carrier that denies a claim it should have paid — or that fails to investigate reasonably before denying — may be liable not just for the policy benefits but for a bad-faith tort on top of them. If your denial looks less like a mistake and more like a strategy, that changes the leverage considerably. See our Arizona bad-faith and underpaid-claim page for how those claims work.
