Thank you, B.Can I appeal this claim?
Yes, of course. Understand that the claim may be appealed through litigation
When you have insurance, you and them have entered into a contract
that they would cover certain things. In a claim, you ask "hey cover this." They can either fulfill their end of the contract, or they can deny it.
If they deny it, you could potentially sue
them to force coverage.How do they know this?
They do not. However, they claim this is so because under contract, wear and tear is not covered, and they hope that you simply give up and walk away.
However, if they refuse to cover a proper claim, one can appeal the matter in court
and have the court decide if the policy
contract covers this or not.
Often, the threat of filing suit can have them reconsider the coverage and offer a certain amount to cover the damage. Why? Because they know that you'll at least get that in Court, if you file suit.
An attorney usually cuts through this malarkey since the adjuster knows counsel does not put up with this and WILL file suit if needed (whereas here, they do not see you as much of a threat without an attorney since you filing or winning a suit without counsel is unlikely). Then a settlement is usually reached. The attorney should take this on a contingency basis, meaning they do not get paid unless you do. Usual set up is their take is 33% settlement, 40% win at trial, 45% at appeal; plus some office costs. Everything is negotiable.
May I recommend the CA Bar referral program - here
. The attorneys are vetted and qualified. You should be able to find an attorney you are confident with and whom you can trust, and who is available ASAP.
I hope this helps and clarifies. Good luck.
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