Why this denial is often beatable
'Wear and tear' is a defensive insurer phrase. To uphold it, they must show the damage was foreseeable and gradual, not sudden. If you can show a triggering event (storm, impact, burst), the denial is usually reversible.
Evidence that overturns the denial
Three things help most:
- Dated photos showing the area was intact recently.
- Weather data for the date of loss (storm reports, utility outages).
- Contractor statement that damage is consistent with a sudden event, not deterioration.
Frequently asked
- How long do I have to appeal?
- Most insurers give 12 months from the denial letter, but regulator deadlines are tighter (often 6 months). Move fast.
- Should I hire a public adjuster?
- For losses under $10,000, usually not worth the fee. For larger losses, yes — they take 10–20% but recover significantly more.
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