3 Reasons You're Having Trouble Collecting an Insurance Payout

When insurance works like it's supposed to, it can be a little like the movie where the sheriff rides into town and rescues you from the bad guys. When insurance doesn't work the way you thought it would, it can also be like the movies -- but the one where the sheriff rides into town and turns out to be the bad guy's best friend.

Homeowners insurance claims can be especially messy, says Bob Freitag, president and founder of AmeriClaims, a public adjuster firm headquartered in Indian Trail, North Carolina. "We see time and time again that insurance companies bring in their approved vendors, who promise to clean everything rather than replace items. This is especially true with fire damage claims."

That saves the insurers money, Freitag says, which would be peachy -- except more often than not, "[the items] still smell smoky," he adds.

And hail is hell. "Insurers aren't wanting to pay for all the hail damage to roofs that we have experienced more of in the last few years. They want to patch roofs or simply say that there isn't enough damage to warrant replacing it," Freitag says.

[Read: 5 Insurance-Buying Mistakes to Avoid .]

So what should you do if you file an insurance claim and your insurer denies it? Here are a few reasons this happens and what insurance experts say you can do about it.

The problem may be in the documentation. Let's say lightning strikes a tree, which falls on your garage and crushes your car. Provided you've made sure everyone is safe, whip out that phone or camera and start taking photos. Treat it like a crime scene. If the detectives -- ahem, insurers -- can't get out to look at the damage for a while -- and you can't leave everything the way it is -- take a lot of photos.

If this is a health insurance issue, the premise is the same: Collect whatever documentation you can involving the claim you're having trouble with. You may need it later.

Then, if your insurer gives you paperwork to fill out, take it seriously, Freitag urges. "When an insurance company first arrives on the scene of a claim, they give policyholders a handful of forms and tell them to fill out the forms and send them back in," he says. "The policyholders must prove their damages to the insurance company. If they fail to document the damages in the correct manner, the insurance company doesn't have to pay for them."

Keep in mind that the insurance company isn't necessarily looking for a way to cheat you. Much of the red tape exists because insurers are trying to avoid being duped by insurance fraud.

Your policy may not cover what you think it does. It isn't always a matter of the insurer being in the wrong. Did you wince at the premiums and decide to go with a lower-cost plan that covers a lot less? If that's the case, "the insured may not have any remedy," says Leigh Needelman, CEO of Florida Assurers, an insurance agency in Miami Beach, Florida.

That stinks, but don't get so angry that you forget to review your policy later and consider upgrading -- or ask your insurance agent to find you a new insurer. You don't want to continue paying your insurer and realize you never improved your coverage the next time an incident occurs.

When it comes to homeowners insurance, another common problem occurs when your coverage hasn't changed but the contents of your house have, says Mark Welzenbach, chief claims officer at the Hanover Insurance Group in Worcester, Massachusetts. He points out that the worth of household items, from art to sports equipment, can add up.

[Read: How to Get Your Insurance Claim Paid .]

And what if you remodel your kitchen to the tune of $20,000, then a grease fire breaks out two years later? If you haven't consulted your insurer, you may not be as fully covered as you hope. The bottom line: "Don't procrastinate and have regrets later," Welzenbach says.

You haven't met your deductible yet. This is so easy and yet so hard to understand. As you probably know, a deductible is the amount you have to pay before your insurer does. It can get very confusing, though, especially when it comes to health insurance, which can involve copays, coinsurance and out-of-pocket maximums.

But generally, as Needelman says, "Sometimes insurance is purchased with a higher deductible in an effort to lower the annual policy premium."

In other words, you may first have to pay a decent amount of money to get your problem fixed before your insurer starts kicking in. Of course, your insurance agent should explain that, which is why Needelman advises consumers to fully utilize their agent. "Your insurance agent earns a commission for handling your insurance needs and servicing your account," he says.

Don't panic. Patrick Bet-David CEO of PHP Agency, an insurance and financial services firm based in Woodland Hills, California, is the author of "The Next Perfect Storm," a book about the life insurance industry. He says some insurance firms are reluctant to quickly make big payouts -- on a large life insurance policy, for example -- because, "Well, imagine how you would feel if you had to shell out $500,000?"

But he says it's rare for insurance companies not to pay, in part because they have access to everything. They can contact the Medical Information Bureau, a consumer reporting agency that likely has your prescription history if you're American or Canadian. Your insurer can also contact the Department of Motor Vehicles and get your driving record.

[See: 10 Things Everyone Should Know About Money .]

"And with [the Health Insurance Portability and Accountability Act], insurance companies can find out absolutely everything related to your health," Bet-David says.

Having what amounts to an insurance Big Brother may sound creepy, but as long as you aren't engaged in insurance fraud, all of that access will pay off for you -- eventually.

"If your claim is legit, it will eventually get processed," Bet-David says.

This isn't exactly the encouraging, snappy motto you'll hear on an insurance television advertisement, but it should make some policyholders feel a little better.