Edmond Consulting Group LLC
Edmond Consulting Group LLC

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Edmond Consulting Group LLC

PO Box 1294




Or you can reach us at 

(803) 716-9901


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Insurance Claim Denied!

Insurance Claim Denied! Why an insurance claim denied depends on many factors. How to win when an Insurance Claim Denied letter is received is what we do as Public Adjusters. Public Adjusters are licensed through the insurance comissioner to work on behalf of home owners and business owners and here at Edmond Consulting Group LLC, we are very familiar with insurance denial. The fact is we see more  Insurance Claim Denied files than any other type of insurance claims related specialist, even more than insurance attorneys. Public Adjusters are often called even before home or business owners call their insurance company – why is that? Because Public Adjusters have the ability to find out quickly the reason the insurance claim is denied and advise the client what to do to recover the money needed to repair their home or business.


Insurance Claim Denied – Our Procedure


Insurance Claim Denied files command top priority. Once a home or business owner signs up with our company we start working for you immediately. Our engagement letter allows us to get the insurance company to send us all relative information concerning your insurance claim. We fully scope the claim to include a maximum number for the damage and we do that in a the same program the insurance companies use which is called Xactimate. We then present our findings to the insurance company and argue the reasons to reverse their Insurance Claim Denial.


The reason for denial can be a simple misunderstanding based upon what you tell the insurance company about your loss when you first call them. For example, if a pipe bursts do to a freeze and you tell the insurance company that your home or business is “flooded” then you have not described the claim correctly and if you do not have flood insurance guess what the determination will be? Insurance Claim Denied … and you might not ever be told that a pipe burst is the actual way to describe your claim and that flooding / flood is actually the result, but that food / flooding isn’t really what occurred. A flood is the result of water entering your home or business from the outside of your property. Every time water is the cause for damage to your property from the inside you are experiencing “sudden and accidental discharge of water.” Please describe it that way if any water damages your property on the inside, and your chance of receiving an Insurance Claim Denied letter will be greatly reduced.


Insurance Claim Denied even if damage is called in correctly


Insurance companies send out Insurance Claim Denied letters even if you have a legitimate claim! Why do you think that is the case? In one word – Profits. Insurance companies are in business to make a profit, and if they paid ever claim every time a claim was filed, they would not be very profitable! As Public Adjusters we have the power to discover the reason for the Insurance Claim Denial, but when insurance companies refuse our very well organized  rebuttal, is the fight over? Absolutely not! Unlike many other Public Adjusting firms, we have a full legal department that has over 11 years of  experience fighting and winning Insurance Denied Claim situations.


Our legal team has won countless of cases with an annual production of many million dollars per year. These are fact we will happy share details about with you in person if you are facing an Insurance Claim Denied situation. For a free consultation, call us now at 678-224-1328 or 803-386-9751 if you have received any kind of denial concerning your home or business.




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