Insurance Claim Rejected

First of all, don’t panic…

If you believe that your insurance claim was unfairly rejected, then there are things that you can do which might make your insurance company reconsider their decision.

Why was my insurance claim rejected?

There are a number of reasons why your claim may have gotten rejected, and it can sometimes be down to a simple error in your claims form.

Reasons why a claim might be rejected:

  • You are claiming for something that your insurance policy just doesn’t cover.
  • You didn’t give your insurance company all the information that they required.
  • You failed to fill the claims form truthfully with accurate information that would have affected your claim.
  • The insurer didn’t feel as if you took sufficient care to prevent the situation.

How can I challenge the insurance company’s decision?

If you disagree with the insurance company’s decision to reject your claim, you need to make sure that you have solid reasoning to back that up. Make sure that you gave all of the correct information when you first purchased your insurance policy, and where in your policy it states that you are covered for what you are claiming for. Read over your submitted claims form, ensuring that everything you filled in was to the best of your knowledge and factual, and that you gave as much information as you could. If there was a change of circumstance sometime within the duration of your policy, locate any letters you sent informing your insurer of the changes and any other evidence that will support you.

If you have an insurance broker through whom you purchased your insurance policy, this would be a good time to contact them and ask for their professional advice. Oftentimes, your insurance broker will even make the complaint for you, providing the insurer with all of the evidence you have to support your claim.

Write a formal letter of complaint to the complaints department of your insurance company. The address should be listed on your policy documents, or you may have to search for it online. Make sure that you clearly write “complaint” at the top of the letter, and date it with your name and policy number. Attach copies of any evidentiary support, and state within the complaint your objections against the claim being rejected referencing your attached documents where appropriate. Inform the insurer that if you aren’t satisfied with their final response to the complaint, you will put the issue forward to the Financial Ombudsman Service.

And if I’m still not happy with the insurer’s final response?

If you have already received a final response from the insurance company and you’re still not satisfied with their reasons for rejecting your claim (or if you have not received any form of reply at all for at least eight weeks since you sent the complaint), then you will be able to make a complaint to the Financial Ombudsman Service.

The Financial Ombudsman Service is a free, independent service that was set up to help resolve disputes between financial services (such as insurance companies) and consumers. They will review all of the documents and complaints (so make sure that you submit all your supporting evidence and correspondence with the insurance company) and make a fair decision based on their investigations into both sides of the story. The decision made by the Financial Ombudsman Service is final, and overrules any decisions made by the insurance company. So if they agree with you that your insurance claim shouldn’t have been rejected, then they have the power over the insurance company to overturn their decisions and make them apologise. If you are still not happy with the final outcome, you will have to take your case to court.

For additional advice in regards to insurance claims, please read our guide on How To Make An Insurance Claim for our recommendations on how to make an insurance claim and get it accepted!

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