Claim denied or underpaid? What to do next

Four steps to appeal

1. Get the denial in writing. Ask your insurer for a letter or email that says what it decided and quotes the exact policy wording it relies on (the section name and the words). A phone call is not enough. Keep every letter, email and note, with dates.
2. Ask for the adjuster's estimate and your claim file. Ask for the adjuster's written estimate, their photos, and any report from an engineer or other expert. Put it next to your own contractor's or shop's estimate and mark each line where they differ. Missed damage and low prices are the most common gaps.
3. Ask for a re-inspection. Ask for a second look, in writing. Be there for it and bring your contractor or shop so they can point out what was missed. Afterward, ask for the new estimate in writing.
4. Use the appraisal section of your policy, if it has one. Look in your policy for a section called "Appraisal". It is for fights over how much the damage costs, not over whether it is covered. Each side picks an appraiser, and the two pick an umpire to settle what they can't agree on. Read that section for how to start it, any deadline, and who pays.

Also find your deadline to sue. Look in your policy for a section about legal action (it is often called "Suit Against Us"). It sets how long you have. Don't let it run out while you wait on an appeal.

File a complaint with your state insurance department

Every state has an insurance department that takes complaints about insurance companies. Filing is free, and you can do it online. It is worth doing when the insurer won't explain its decision, stops answering, or keeps delaying.

Include:

• Your name, your policy number and your claim number.
• The denial letter, or the letter with the amount the insurer offered.
• A short timeline: when the damage happened, when you reported it, and every contact since.
• Your own estimate and photos.
• What you want: for example, a re-inspection, a written reason, or payment of a specific amount.

Here is the official complaint page for every state we cover. We opened each one on the state's own site on October 19, 2026, except Arizona's: that site blocked our check, so it is marked "Not verified".

Not listed? Search for your state's name plus "department of insurance complaint", and make sure the site ends in .gov.

What a public adjuster is

A public adjuster is a licensed adjuster you hire to handle a claim for you. The adjuster your insurer sends works for the insurer. A public adjuster works for you: they measure the damage, write the estimate, and argue with the insurer over the amount. They mostly handle home and business property claims.

They are usually paid a share of what the insurer pays on the claim. That share comes out of your check. Before you hire one:

• Check the license with your state insurance department.
• Read the contract. It should state the percentage, what it applies to, and how to cancel.
• Don't sign at the door right after a storm. Take the contract home and read it first.
• Ask whether the fee applies to money the insurer already paid. Florida, Kentucky, New York, Tennessee and Virginia don't allow a fee on money paid before you signed.

Some states cap the fee by law. Of the 23 states we checked, 14 have a cap (in Colorado, North Carolina, Virginia and Wisconsin, only after a declared disaster). Louisiana doesn't allow a percentage fee at all. In 8, we found no cap in state law.

"No cap found" means we read the state's public adjuster laws and rules and found no limit on the percentage. The fee is then whatever the contract says.

When a lawyer makes sense

Most fights over the amount get settled by the steps above. A lawyer who handles insurance claims for policyholders makes sense when:

• A lot of money is at stake, well above your deductible and above what a lawyer would cost.
• The insurer says the damage isn't covered at all. That is a question about what the policy means, and appraisal can't settle it.
• The insurer accuses you of fraud, or asks you to give a sworn statement (an "examination under oath").
• Someone was hurt, or someone is suing you.
• Your deadline to sue is close.

To find one, your state bar association can refer you to a lawyer who handles insurance disputes. Ask at the first meeting how they charge: by the hour, a flat fee, or a share of what you recover.

Questions people ask

Can I appeal a denied insurance claim?

Yes. Start by asking your insurer, in writing, for the denial letter and the exact policy wording it relies on. Then ask for the adjuster's estimate, ask for a second inspection, and use your policy's appraisal section if the fight is over the amount. If that fails, file a free complaint with your state insurance department.

How do I file a complaint against my insurance company?

Go to your state insurance department's complaint page (we list the official page for every state we cover) and file online. Include your policy number, your claim number, the denial letter, and a short timeline. It costs nothing.

What does a public adjuster charge?

A public adjuster is usually paid a share of what the insurer pays on the claim. Some states cap that share by law. Of the 23 states we checked, 14 have a cap in state law, though in 4 of them it applies only after a declared disaster. Louisiana doesn't allow a percentage fee at all. Read the contract before you sign: it states the fee.

What is the public adjuster fee cap in Florida?

Florida law caps a public adjuster's fee at 20% of what the insurer pays. For an event the Governor has declared an emergency, the cap is 10% for claims made in the year after the declaration. The adjuster can't charge anything on money the insurer paid or agreed in writing to pay before you signed. If the insurer pays or agrees to pay the full policy limit within 14 days of the loss (or 10 days after you sign, whichever is later), the fee is capped at 1%. These caps are in section 626.854(11) of the 2026 Florida Statutes.

Do I need a lawyer for a denied claim?

Not always. Many disputes over the amount get settled by a re-inspection, appraisal or a state complaint. A lawyer makes sense when a lot of money is at stake, the insurer says the damage isn't covered at all, the insurer accuses you of fraud, someone was hurt, or the deadline to sue is close.

Sources

Complaint pages: each state's insurance department site, linked in the table above. We opened 22 of 23; the rest are marked "Not verified".

• Arizona fee cap: A.R.S. §§ 20-321 to 20-321.03: “An adjuster may not participate either directly or indirectly, including as contractor or subcontractor, in the restoration, reconstruction or repair of any damaged premises or property” Source.
• California fee cap: Cal. Ins. Code § 15027: “shall not cause the insured to receive less than any amount paid to the insured by the insurer prior to the date of the written contract” Source.
• Colorado fee cap: C.R.S. § 10-2-417(4): “any payment, commission, fee, or other thing of value in excess of ten percent of any insurance settlement or proceeds” Source.
• Connecticut fee cap: Regs. Conn. State Agencies § 38a-788-8: “No public adjuster shall receive compensation in excess of 10% of the actual or final settlement of a loss covered by the employment contract.” Source.
• Florida fee cap: Fla. Stat. § 626.854(11)(b) (2026): “Twenty percent of the amount of insurance claim payments or settlements, exclusive of attorney fees and costs, paid to the insured by the insurer” Source.
• Georgia fee cap: O.C.G.A. § 33-23-43.3(a): “the total commission received shall not exceed 33.3 percent of the amount of the insurance settlement of the claim” Source.
• Illinois fee cap: 215 ILCS 5/1570(d)-(e): “accept any compensation, payment, commission, fee, or other valuable consideration in excess of 10% of the amount of the insurance settlement claim paid by the insurer on any claim.” Source.
• Kentucky fee cap: KRS 304.9-4333(2)(b): “May charge a reasonable fee that does not exceed ten percent (10%) of the insurance settlement proceeds upon which a fee may be based under this section.” Source.
• Louisiana fee cap: La. R.S. 22:1703(A): “provides for payment of a fee to the public adjuster which is contingent upon, or calculated as a percentage of, the amount of any claim or claims paid” Source.
• Massachusetts fee cap: M.G.L. c. 175, § 172: “subject to the public insurance adjuster's assertion of a lien for his agreed percentage fee upon insurance proceeds offered or secured through his efforts” Source.
• Michigan fee cap: MCL 500.1226(3): “shall not charge a rate for his or her services which exceeds 10% of the amount paid by the insurer in settlement of the loss.” Source.
• Minnesota fee cap: Minn. Stat. § 72B.135: “The public adjuster shall disclose in writing to the client the fee charged by the public adjuster.” Source.
• New Jersey fee cap: N.J.A.C. 11:1-37.13(b)3ii: “A list of services to be rendered and the maximum fees to be charged, which fees shall be reasonably related to services rendered” Source.
• New York fee cap: 11 NYCRR § 25.7(a): “No public adjuster shall charge a fee in excess of 12.5 percent of the recovery for services rendered by the adjuster, with respect to a claim” Source.
• North Carolina fee cap: N.C. Gen. Stat. § 58-33A-60(d): “any payment, commission, fee, or other thing of value equal to more than ten percent (10%) of any insurance settlement or proceeds” Source.
• Ohio fee cap: Ohio Adm. Code 3901-1-24(E); R.C. Chapter 3951: “Every such contract must conspicuously set out the fee of the public insurance adjuster for the adjustment services to be rendered the insured pursuant to the contract.” Source.
• Pennsylvania fee cap: 63 P.S. § 1605 (Public Adjuster Licensing Law, Act 72 of 1983): “Fees to be charged or assessed by the public adjuster together with an explanation about how the fees will come from a portion of the claims payment” Source.
• South Carolina fee cap: S.C. Code § 38-92-120(E) (2026 Act No. 209): “any payment, commission, fee, or other thing of value equal to more than ten percent of any insurance settlement or proceeds” Source.
• Tennessee fee cap: Tenn. Code Ann. § 56-6-913(a): “may not charge a fee that is greater than fifteen percent (15%) of the total proceeds of the insurance settlement.” Source.
• Texas fee cap: Tex. Ins. Code § 4102.104: “The total commission received may not exceed 10 percent of the amount of the insurance settlement on the claim.” Source.
• Virginia fee cap: Va. Code § 38.2-1845.14(C): “any payment, commission, fee, or other thing of value equal to more than 10 percent of any insurance settlement proceeds.” Source.
• Washington fee cap: Chapter 48.17 RCW: “a statement of any fee, commission, or other compensation received or to be received by the adjuster on account of such investigation or adjustment” Source.
• Wisconsin fee cap: Wis. Stat. § 629.05(6): “may not receive compensation in excess of 10 percent of an insured’s actual recovery under the insurance policy if the claim is due to a catastrophic disaster” Source.

We read every cited source on October 19, 2026. We cite statutes, regulations and official insurance department pages, never law-firm, public adjuster or comparison-site summaries. Anything we could not check against a primary source is marked "Not verified".