If you file claims on your insurance policy, the insurance company could say that they’ll not make a payment or only pay a portion from the total amount declared. There are many reasons for this to occur and a variety of ways you can do about the issue.
How can your insurance claim get rejected?
There are many reasons an assertion could be rejected in a fair or non-fair manner. The reasons are listed below.
Incorrect information
It is possible that you have provided insufficient or incorrect information in your claim, either deliberately or accidentally. For instance, what happened or how it occurred or was damaged.
The insurance company believes that you didn’t exercise’reasonable care’
The majority of policies have a’reasonable care or ‘duty of care’ clause which will require you to take the necessary steps to stop a claim occurring. For example, if , for instance, you placed your valuables in a the floor of your car or in the car, your insurance company could see this as an excuse to deny your claim.
Inaccuracies, omissions or mistakes within your insurance application
The insurance company can deny the claim of a customer if there is a reason to believe that you did not take reasonable precautions to answer all questions asked on the application honestly and in a timely manner. An example of this is the failure to reveal any medical condition that was pre-existing.
Technical “sticking points”
Insurance companies may find “small print” arguments to dispute your claim. For instance, they could argue that the item that was stolen or lost was used for business or personal purpose. If the latter is true the item may not be covered under the policy.
The proper claim procedure wasn’t being followed.
Insurers typically expect their customers to adhere to the rules and may claim that you’re not following their claims procedure in a way that is sufficient to justify refusing to accept it.
The insurance company insists that it will only pay the amount of the claim.
This could occur, for instance in the event that your policy does not provide enough insurance to cover your losses. You’ll need pay an extra amount when the insurance company believes that you’ve undervalued your claim.
If you’re unhappy with the reasons offered by the insurance provider for refusing to pay your claim, you’re entitled to file a complaint.
What do you do if believe your claim shouldn’t been denied
Make sure you have the policy documents of your company.
Review the specifics that you have included in the policy determine whether the information you have provided is in line with the reason behind the rejection.
It is worth challenging the decision in the event that you believe that it was not fair to reject it. This is because such rulings can be rescinded (often after submitting this to Financial Ombudsman Service – find out more about this in the following):
Verify that you provided necessary information in the beginning.
Highlight or write down the exact phrase in your insurance policy that states you’re covered . You’ll require it in the future.
If the words are unclear or unclear, write it down. The insurance company has a responsibility to provide clear information , and they have to give an adequate explanation as to why they are not paying your claim.
The new rules stipulate that an insurance company cannot refuse to accept your claim if they were able to answer all of their questions truthfully as well as to your best ability. If your insurer did not request information, but they’re now saying that you must have disclosed the information in a timely manner and noted that as well.
Did the insurance company ask you for the information it claims you should have divulged? If not, take an note of it.
You can also look up any other documents which is related with your policies.
For instance, if you wrote an insurance firm a note informing that they had changed your situation (this is your obligation) Try to locate the original letter.
Make contact with your insurance provider
After you’ve had a look through your policies, you’re now ready to reach out to your insurance provider.
You can call the company to speak with their complaints handlers . You can also compose an official letter of complaint, and send it to the address listed in the complaints procedure of the company.
Your complaint will then go through the internal review procedure. You may request more details about this if would like to.
Get in touch with resclaim.co.uk for insurance claim rejected help.
If you purchased your insurance via an insurer they may be able to handle your complaint for you. It’s worth askingto spare yourself the headache.
How do you write an official complaint letter
Here are some suggestions for how to write your letters of complaint:
Place your date of birth on the note.
Name and your policy number.
The letter ‘complaint’ should be placed in bold letters on the top.
Include any evidence you can to back up your claim.
Write what you want for the business to take action to fix things right.
Be clear in your explanation of your complaint by stating the reasons why your claim shouldn’t be denied.
Declare that you’re dissatisfied with the response of the company. You’ll refer the matter before the Financial Ombudsman Service.
Request an independent assessment
If the issue is a technical issue or a specialist issue It may be beneficial to obtain an independent evaluation. For instance, if the insurer claims that the damages to your property occurred caused by wear and tear but you’re trying to argue that it was caused by an accident.
It’s worth contacting an assessment specialist (not not to be confused with loss adjuster who is employed by an insurance firm) to assess the damage and provide a assessment to insurance companies to provide evidence.
You should be aware of the fact that these companies will charge you a cost for representing you.
If it doesn’t change the insurer’s mind but it could be helpful data to keep for later.
Visit the Financial Ombudsman Service
If you’re still unsatisfied after having gone through the complaints procedure, you’re entitled to the right to bring complaints to Financial Ombudsman Service.
The Financial Ombudsman Service is an independent, no-cost service that investigates complaints made by people about financial firms.
If you bring your issue directly to the authorities, they’ll look at each side of the story, take a look at the documents and try to reach a fair conclusion using the evidence and the commonsense.
You are only able to file a claim after receiving the term “final response from your insurance company after eight weeks gone by and you’ve not received any response from them.
If they find that your claim was incorrectly denied The Financial Ombudsman Service have the ability to order an insurance firm:
Explain the actions of the company.
apologize for your actions, and
make compensation payments or take actions to alter the result.
Make sure you send it along with the copy of the last answer letter sent by your insurance company as well as any other documents to support your claim.
Do I require an “expert for help with my issue?
You shouldn’t require any help or assistance when you have a complaint.
The Financial Ombudsman Service is a non-cost and informal service. We we would love to hearing from the person you speak to in your own voice.
Everyone is entitled to have someone else take action on their behalf.
A few people may prefer to ask somebody from community Citizens Advice or a relative or friend who can assist the person with their complaint.
If you do decide to hire someone to argue your case on your behalf like an insurance company that handles claims You may have to cover their costs.
It could be that you pay them a percentage of the compensation you’re awarded.