What to do if your home insurance claim is rejected

The last thing you need when disaster strikes is to find out that your home insurance provider has refused to pay your claim. Here we explain the possible reasons why your claim has been rejected and what you need to do now.

The last thing you need when disaster strikes is to find out that your home insurance provider has refused to pay your claim. Here we explain the possible reasons why your claim has been rejected and what you need to do now.

Rachel Lacey
Insurance and money expert
6
minute read
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Last Updated 26 SEPTEMBER 2022

Why has my home insurance claim been denied?

There are many reasons your claim may have been rejected by your home insurance provider.

Amongst the most common reasons are:

  • Lack of cover – this is where you have attempted to claim for something that’s not actually covered by your policy, like your dog tearing up the sofa. Most policies will not cover damage caused by pets. Accidental damage  will cover many mishaps – like wine or paint spilt on a carpet – but it doesn’t come as standard on most policies. You’ll need to have requested it when you took out the policy and paid an additional premium for it.
  • Wear and tear – home insurance policies will usually say that you need to keep your property ‘well maintained’. So if you make a claim for damage caused by a roof tile that became dislodged during a storm, it may be rejected if your insurance provider can see that your roof has not properly been looked after.
  • Incorrect information – if you give your insurance provider incorrect information, there’s a chance your claim could be rejected. An example might be giving incorrect details about how your kitchen was damaged. It’s essential you make your claims form as detailed and accurate as possible.
  • Lack of due care – this is where something you’ve done, or not done, may have led to an incident that triggers the claim. For example, a theft claim is unlikely to be paid if there is evidence that you hadn’t locked your front door, or left a window open.
  • Non-disclosure of facts – your claim might be rejected because you haven’t been truthful with your insurance provider. Never give misleading information and don’t try to hide previous claims just to maintain your no-claims discount. You should also tell your provider about a significant change in your circumstances, like changing jobs or getting married.
  • Too late with the claim – sometimes claims are rejected if too much time has passed. Many insurance providers require you to notify them of your intention to claim as soon as possible after the event, while some may offer a grace period of up to 180 days. As always, check your policy documents just to be sure.

Why might an insurance provider not pay out the full amount of your claim?

In some instances, your home insurance claim might not be rejected outright. Instead, your insurance provider may agree to pay out a portion of the amount you’ve claimed for. This usually happens if you’ve underinsured your home or its contents, or if the insurance provider thinks you’ve put an unrealistic value on your claim.

Underinsurance

With underinsurance, your insurance provider might mention something called the ‘average’ clause, which is part of standard insurance policies. This says that if the sum insured you choose is say, 25% under what it should be, then any claims pay-out will also be reduced by 25%.

Let’s say you have £40,000 of contents but only bought £30,000 worth of insurance, a claim for £20,000 might only result in a £15,000 pay-out. This is why it is so important to have an accurate sum insured.

Single item limits

The single item is the maximum your insurance provider will pay out for any one item. So if you claim £2,000 for a stolen engagement ring, but your single item limit is £1,500, this is the maximum pay out you can receive.

You can still arrange for items above the single item limit to be fully insured, you just need to tell your insurance provider and pay an additional fee.

If you’re concerned you have valuable items that may not be fully covered, check your policy and contact your insurance provider before it’s too late.

What can I do if I feel my insurance provider has refused my claim unfairly?

It’s incredibly frustrating to shell out for insurance only to find out it won’t pay out when you need.

But if you have a grievance with your insurance provider, it’s best to take a calm and measured approach.

This means that when you make your complaint, you need to clearly state why you think your claim is justified.

Check your policy documents

The first step is to check your policy to help back up your claim and the reasons you feel it’s valid.

  • Note down any wording that is ambiguous or needlessly complex
  • Highlight the exact policy wording that says you’re covered
  • Jot down any information your provider didn’t ask for in the policy documents that they’re now saying you should have voluntarily disclosed
  • Find any correspondence you have letting your provider know about a change of circumstance that might have affected your policy, like moving house

Contact your insurance provider

The next step is to try to negotiate with your insurance provider to sort out the underlying issue behind the refusal. For example, if your provider has rejected your claim because you haven’t provided enough information, you can offer to elaborate.

If your insurance provider isn’t willing to negotiate and you still feel your claim has been unfairly rejected, you’ll need to make a formal complaint and follow its complaints process.

What do I need to include in my complaint?

If you choose to make your complaint via a letter, you should include:

  • the date, your full name and your policy number
  • any supporting evidence within the body of your letter and the main reasons behind your complaint
  • a clear outline of what you expect the insurance provider to do to make things right

Always proofread your letter before sending it, making sure you haven’t left out anything important.

If you talk to your insurance provider on the phone, keep a record of when the conversation took place, who you spoke to, what was discussed and, if relevant, what was agreed.

Keep any emails on file.

What if my complaint isn’t properly dealt with?

If you aren’t happy with your insurance provider’s response, or you don’t get a response within eight weeks, you can contact the Financial Ombudsman Service for help.

It can investigate your complaint for you. The service is unbiased and provided free of charge.

If the FOS believes that your insurance provider was wrong to reject your claim, it will uphold your complaint and can force the company to rectify the situation.

Switching home insurance providers

Compare the Market can make the process of switching to a new provider as simple as possible. We’ll help you compare quotes from various other reputable home insurance providers in the UK. Let’s get started and see if you can save…

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