How to overturn rejected insurance claims
Published: 06/04/2016
Having to claim on your insurance can be a stressful time, particularly as it usually means something bad has happened in the first place. However having an insurance claim rejected makes a bad situation even worse. If you believe your insurance company has unfairly rejected your claim then there are steps you can do to try and reverse the decision.
Common reasons for rejected insurance claims
- Lack of accuracy
Whenever you take out insurance it is vital you complete the questionnaire honestly and to the best of your knowledge even if you suspect it may increase the cost of your insurance. If you fail to do so you are likely to have any claims you make against your policy rejected. This includes any pre-existing medical conditions, incorrect description of door locks and any criminal convictions. - Failure to update policy
If your situation ever changes or if the items you have insured have been modified in any way it is your responsibility to inform the insurance provider of these changes (remember to keep a copy of this correspondence). For example, if you have a mobile phone on your contents insurance and then get an upgrade you need to update these details. - Lack of due care
You have a level of responsibility to keep your valuables safe so leaving them in plain sight, such as leaving your phone in your car, could be considered lack of care and therefore void your insurance. - Social media bragging
There are an increased number of insurance claims being rejected due to social media posts. Insurance companies are starting to argue that by posting on social media that you are away on holiday, for example, classes as ‘lack of due care’ as you are basically telling everyone your house is empty. - Forgetting to notify the police
If you have been a victim of theft, you need to inform the police within 24 hours. They will then issue you with a crime number which you will need to provide when you submit a claim.
If you believe you have not done any of the above then you have the right to raise a complaint.
Making a complaint
The first thing you need to do before submitting a complaint is to thoroughly check your policy documents and see if the reason for the rejection is valid.
Ensure all the details you gave were correct and up-to-date. It’s difficult but try and be as objective as possible – maybe even get a family member or friend to review it as well to get a more impartial perspective.
Whilst reviewing the documents, highlight the exact wording of your policy explaining what you are covered for. Also note down anything which is ambiguous or unclear. Insurance company must provide clear information; if the details are poorly explained this could help you with your complaint.
Check your insurer asked for all the information. If they are claiming you should have provided information that they did not directly ask for then this may help your case.
If you took out the insurance policy through a broker it may be worth contacting them in the first instance as they may make the complaint on your behalf.
Contacting the insurance company
Once you have reviewed your documents and believe your claim was unfairly rejected, you should now contact your insurance company. You can phone them and ask to speak to their complaints handler or, if you prefer to have everything in writing, you can write a formal letter of complaint and send it to the company’s complaints department. All contact information should be available on their website.
If you choose to write a letter, make sure to include:
- The date
- Your name and policy number
- The reason for your complaint with an explanation of why you believe your claim was unfairly rejected
- Any evidence you have to support your complaint (e.g. details of your policy)
- The actions you would like to insurance company to take.
Sign off the letter by stating if you remain unhappy with the response you intend to take your complaint to the Financial Ombudsman Service.
Financial Ombudsman Service
The insurance company should provide a ‘final response’ within eight weeks. If they fail to so within this timeframe or if you remain unhappy with the outcome you can then escalate it to the Financial Ombudsman Service.
If they agree your claim was unfairly rejected, they can make the insurance company pay compensation. They will also need to explain their action and even provide you with an apology!
If the Ombudsman finds the insurer is within their rights to reject the claim you can take your claim to the small claims court. Read our article Small Claims Court: How to bring a claim.
Content correct at time of publication