Has your insurance claim been rejected? Here’s what to do next
It’s the news none of us hope for: our property has been damaged through no fault of our own, but our insurance provider has decided that our claim doesn’t meet their eligibility criteria, and we won’t be receiving what we believe we are owed.
Unfortunately, this situation is not as rare as you might think.
Recent research has shown that around 18% of claims are rejected by insurers every year – and with more than 1.23 million claims being made every single day, that’s a lot of people who are feeling the sting of rejection at what is already a stressful time for them and their families.
If this happens to you, rightly or wrongly, it’s important to know what the next steps are for a fast resolution.
Your claim might have been rejected because:
- Your existing insurance policy doesn’t cover it
- You have failed to disclose vital facts on your insurance claim form
- You have not followed the correct claims procedure
- Your insurer believes that the damage sustained at your property is through wear and tear, not because of an accident or an instance that was beyond your control
- You have failed to exhibit due care – for example, by not locking your door while you are not at home, and suffering a burglary as a result
If you are adamant that your claim should not have been rejected, you will need to follow the below process:
- Contact your insurance company right away to clarify the reason for the rejection and see if there is any room for negotiation. Some insurers will be open to a conversation; others won’t.
- Double check your policy document to see if you can find specific wording that validates your claim. If any of the points in your policy are ambiguous or difficult to understand, make a note of them, as you may need to bring these to your insurer’s attention later.
- If your insurer believes you did not inform them of a chance in circumstances at your property, and this is the reason your claim has been rejected, be sure to find and collect written evidence (such as letters and emails) that proves you did in fact let them know.
If it’s time to make an official complaint…
Some insurers will want you to collect all your grievances into a letter. This is often the best way to approach a complaint, as your evidence and argument will be in writing.
However, if you do need to speak to a representative over the phone regarding your case or your complaint, make sure you note down their name, the date of the conversation, and what was discussed.
If you have tried everything to settle the dispute and get your complaint resolved, but are having no luck with your insurer, the next step is to contact the Financial Ombudsman Service. This body will look at your situation impartially and take action with the insurer if they believe your case has been unfairly dismissed.
Save the frustration. Bring in a loss assessor to negotiate with your insurance company on your behalf
The other option is to bring a loss assessor (such as Your Claim) into the negotiation to prevent valid claims being repudiated. Ideally, we like to be appointed before you make the claim to review your policy cover and to pre-validate the claim before it is filed. Sometimes we are able to overturn repudiated claims and have the claim reinstated at full value, after it has been rejected.
Your Claim will examine the situation and help you work out whether your insurer is right to have closed your case, or whether there is scope for renegotiation based on the type of damage sustained at your property and the terms of your policy.
Having an experienced third party on hand can make all the difference when liaising with insurers – and it will give you peace of mind that you have achieved the fairest possible outcome, based on your circumstances.
