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Claims denied by insurance companies

Has your insurer rejected your claim in whole or in part? At MataSeguros, we analyse the rejection and take action to ensure you get what you are entitled to.

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We challenge your denied claim with evidence and a clear methodology

Whether your claim is denied due to alleged pre-existing conditions, lack of maintenance, inheritance issues, late payment of the insurance premium, incorrect classification of the loss, or a restrictive interpretation of the policy — or if the compensation is insufficient to carry out proper repairs — the MataSeguros team is here to help you with a wide range of solutions to review, claim, and maximize what you are entitled to.

TECHNICAL ASSESSMENT AND EXPERT APPRAISAL
Analysis of the actual extent of damage to a home or business, and comparison of expert reports to identify omitted items, hidden damage, and undervalued assessments or claim denials.
REVIEW OF YOUR POLICY

Coverage, exclusions and limits applied

REVIEW OF CLAIM DENIALS

Review of rejected claims to determine whether the denial is based on a valid exclusion or on a disputable interpretation of the policy.

CLAIM FOR UNINHABITABILITY
Claim for accommodation and rental expenses, as well as related losses, when the home cannot be occupied following a covered loss.
LEGAL SUPPORT AND CASE MANAGEMENT
Preparation of technical and legal submissions and arguments to challenge claim denials based on alleged pre-existing conditions, delays in premium payment, or inheritance matters.
NEGOTIATION AND CASE CLOSURE
Item-by-item review and negotiation with the insurer’s loss adjusters to correct reductions, reopen rejected items, and speed up payment when the case has stalled or been denied.

Casos Frecuentes

  • Rejection of compensation claims due to underinsurance

    Ver caso detallado

  • Incorrect application of exclusions

    Ver caso detallado

  • Compensation lower than the actual amount of damages

    Ver caso detallado

  • Prolonged delays without response

    Ver caso detallado

  • Rechazos de siniestros en viviendas heredadas o con el titular fallecido, donde la aseguradora alega falta de actualización de la póliza, errores formales o cambios de titularidad para no pagar. Analizamos si el rechazo es válido o una excusa técnica para evitar la indemnización.

    Rejection of claims in inherited properties or properties where the policyholder has passed away, in which the insurer alleges lack of policy updates, formal errors, or changes in ownership in order to avoid payment. We analyze whether the rejection is valid or merely a technical excuse to deny compensation.
    Ver caso detallado

  • PROPERTY UNINHABITABILITY

    The home cannot be used, but the insurer does not recognize this situation, requires invoices to provide alternative accommodation, or disputes that the property is uninhabitable.
    Ver caso detallado

Preguntas Frecuentes

Yes, they can, but not always justifiably. Many refusals are based on restrictive interpretations or errors in assessment.
The time limit depends on the type of insurance, but there is a legal time limit from the date of notification of the refusal.
Underinsurance occurs when the property is insured below its actual value and can reduce compensation, but not always justifiably.
In many cases, yes, because the policy may cover the damage or there may be interpretations favourable to the insured.
Yes, in many cases. The fact that the insurer states there is no coverage does not mean that the interpretation is correct. It is common for coverages to be misapplied, exclusions to be interpreted incorrectly, or damage not to be properly assessed. A technical review of the policy and the loss makes it possible to determine whether the rejection is valid or whether there is a real basis for a claim.
Denials based on the fact that the policyholder has passed away, an inheritance is in progress, or ownership has not been updated. We analyze whether the rejection is valid or whether the loss can still be claimed in accordance with the Insurance Contract Act.

The insurer closes the claim after the loss adjuster’s visit without paying compensation, alleging “lack of coverage,” “non-compensable damage,” or “insufficient damage,” without analyzing the true extent of the loss.

Discover how we can help you protect your rights and get the maximum return against your insurance company.

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