Lack of Maintenance Denial

A lack of maintenance denial occurs when an insurance carrier claims the loss would not have happened if the policyholder had properly maintained the property. This is a Industry Practice denial reason. Most insurance policies do not actually require active maintenance as a condition of coverage—they require the property to be in normal condition at the time of loss.

This is critical: Most policy language does not deny coverage for losses resulting from deferred maintenance. Instead, policies require that the property be in "reasonably maintained condition" at the time of loss.

• Reasonably maintained: The roof is still intact, the plumbing is functional, the electrical system works.
• Not requiring active maintenance: The carrier cannot deny a roof leak because you did not have the roof pressure-washed every year.

• The policy does not explicitly require specific maintenance tasks.
• The loss occurred suddenly despite reasonable upkeep (a pipe bursts in winter even though heat was on).
• The adjuster is inferring maintenance failures without evidence (claiming roof was poorly maintained without inspection of drainage or installation).

• Review your policy for any specific maintenance requirements. Most do not have them.
• Document your maintenance history (receipts for repairs, contractor visits, seasonal maintenance).
• Determine whether the loss was preventable through maintenance or sudden despite normal care.
• Compare the carrier's claim of poor maintenance to actual conditions when loss occurred.