The good news? You don’t have to. That’s exactly what your insurance broker is here for. Here’s how we can help you make sense of your denial, advocate for a fair review, and guide you every step of the way.

Step 1: Call Your Broker

If you’ve received a denial, or even if your claim feels like it’s dragging on, reach out to your broker right away.

Chances are, you worked with a broker when you first purchased your policy. That same person is your lifeline now. When you call, your broker will:

• Review your denial letter and policy documents.
• Ask about the situation and what’s already been submitted.
• Advise you on what additional information might strengthen your case.

In other words, you don’t need to decode your policy or chase adjusters yourself—that’s what brokers are here for.

And ideally, this isn’t just a step you take after a denial. The best time to involve your broker is the moment you file a claim. They can help you understand what information to include, what timelines to follow, and how to avoid potential red flags that might lead to a rejection in the first place.

Step 2: Review Your Policy—Together

Insurance policies aren’t exactly light reading. Between exclusions, conditions, and endorsements, it can feel like you’re reading another language. But tucked in all that fine print are the details that make or break your claim—and your broker knows where to look.

They’ll help you:

• Identify what’s covered and what’s excluded.
• Check if the insurer’s reasoning aligns with your actual policy wording.
• Spot vague or contradictory language that might work in your favour.
• Clarify any conditions that could have affected the decision.

For example, many policies exclude gradual damage but cover sudden and accidental events. If your basement flooded because of a burst pipe, but the insurer says it’s “maintenance-related,” your broker can clarify the situation, point out the relevant policy language, and push for the claim to be reopened. You might also see something like “damage excluded due to improper maintenance” without any explanation of what “improper” actually means.

We’ve seen countless cases where a second look changed everything. That’s why having someone who understands both the technicalities and the real-world context matters so much.

Step 3: Sit Tight—Let Your Broker Take the Lead

Once your broker has reviewed your policy and denial letter, they’ll step in to communicate directly with the insurer. At this stage, it’s important that you provide any additional documents or information your broker requests—like receipts, photos, or contractor estimates. The more evidence they have, the stronger your case will be.

In many smaller brokerages, the same account manager who handles new clients also manages claims. That can slow things down when you’re waiting for updates or decisions. Larger brokerages, on the other hand, have a higher volume of claims, which can make it harder to get personalized attention or have someone really review your details.

But at PROLINK, you’ll have a dedicated Claims Advocate whose only job is to guide you through the process, speak with the adjuster, present any new evidence, and ask the right questions to ensure the claim is reassessed fairly. If the issue comes down to a misunderstanding or a missing detail, it’s often resolved quickly once a specialist steps in.

Because when you’re already dealing with the stress of a damaged car, flooded basement, or unexpected repair bill, the last thing you need is more back-and-forth.

Step 4: If the Insurer Still Says No

Sometimes, even after all that, the insurer won’t change their decision. That’s when your broker can help you take the next step: a formal appeal.

They’ll help you organize your evidence, reference the right clauses in your policy, and write a professional, well-structured appeal letter.

And they’ll stay with you through the process—tracking deadlines, following up with the insurer, and ensuring your appeal gets the attention it deserves.

Why an Insurance Broker Matters: Real Life Stories

When a claim is denied, it’s not just about money; it’s about your home, your car, your sense of security. And in those moments, having someone on your side who knows how to navigate the system can make all the difference.

If your brokerage doesn’t have a dedicated Claims Specialist, it might be time to find one. Our in-house Claims Advocate is dedicated to helping clients like you through tough situations. Here are just a few examples of how advocacy has turned things around:

• Adjuster Error: A rental property owner was denied coverage for lost rental income after a flood because the adjuster misread the policy. Once we reviewed the documents and clarified the wording, the coverage was reinstated.
• Incorrect Deductible: An auto claim was incorrectly classified as a single-vehicle collision, which meant the deductible was higher. After our Claims Advocate spoke with the insurer and provided evidence, the error was corrected, and the deductible was adjusted.
• Overlooked Coverage: One family displaced by fire was told they weren’t eligible for Additional Living Expenses. We found the clause in their policy that proved they were covered and worked with the insurer to fix it.
• Language Barrier: Another client’s claim was denied due to a misunderstanding in their explanation. English wasn’t their first language, and details were lost in translation. We stepped in to clarify and ensure their claim was fairly reviewed.

These situations all had one thing in common: a client who didn’t have to face their insurer alone. Because claims are stressful. Denials are even worse. But you don’t have to take on the system by yourself.

The Bottom Line

Don’t wait for a denial—contact your broker as soon as you need to file a claim. They can’t report it for you, but they can walk you through each step, help you understand what to include, and make sure your claim is set up for success from the start.

At PROLINK, we believe you deserve to be heard, understood, and treated fairly. If you’re ever uncertain about your coverage, we’ll review it with you. If something doesn’t make sense in your denial letter, we’ll help you decode it. If the insurer goes silent, we’ll follow up. And if we believe the decision was unfair, we’ll escalate the issue on your behalf. Your broker isn’t just there for the sale. We’re here to help when it matters most.

So if your claim’s been denied, don’t panic. Take a closer look, gather your details, and remember: the first “no” doesn’t have to be the final word.