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What to do if your home insurance claim is rejected

You’ve submitted a claim to your home insurance provider, but they’ve notified you that your claim has been denied. Why has this happened? And what now? We investigate. 

You’ve submitted a claim to your home insurance provider, but they’ve notified you that your claim has been denied. Why has this happened? And what now? We investigate. 

Chris King
From the Home team
minute read
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Posted 19 DECEMBER 2019

Why has my home insurance claim been denied?

One of the most common reasons why your insurance provider might deny your home insurance claim is that you’ve tried to claim for something that’s not actually covered by your policy.

Other common reasons include not providing enough information in your claim application form, or perhaps not including correct information. It’s essential you make your claims form as detailed and accurate as possible.

Lack of due care or contributory negligence is another possible reason for a claim being rejected. This is where something you’ve done or not done may have led to an incident that triggers the claim. For example, some of your home’s contents being stolen because you forgot to lock your door.

Your claim might also be rejected because you haven’t told your insurance provider about a significant change in your circumstances, such as changing job or getting married.

Perhaps you haven’t followed the claims process correctly? 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 for which you’ve claimed. 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.

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%.

That means, if 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 choose an accurate sum insured.

It’s always a good idea to check your policy documents to find out how much your insurance provider is willing to pay out on a single item. If you have something worth more than this amount, you’ll have to list it separately on the policy and perhaps pay a higher premium to get it covered.

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

The first step is to check your policy documents to help back up your claim and the reasons you feel it’s valid. Then try to negotiate with your insurance provider or 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 unique complaints process.

What do I need to include in my complaint?

If you choose to make your complaint via a letter, include the date, your full name and your policy number. You’ll need to include any supporting evidence within the body of your letter and detail the main reasons behind your complaint.

Clearly state what you expect the insurance provider to do to make things right and be sure to proofread it multiple times before sending, making sure you haven’t left out anything important.

If you talk to your insurance provider on the telephone, always 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 feel this is the case, you may decide to take things further by approaching the Financial Ombudsman Service for help. You can do this if your insurance provider hasn’t resolved your complaint within eight weeks, they’ve decided to reject your complaint, or you don’t agree with their final reply.

The service is free and focused on assessing the matter from an unbiased point of view. If your claim is indeed deemed to have been wrongfully denied, the Ombudsman Service has the power to insist on an explanation, an apology and that the original amount claimed is paid out (if appropriate to your claim).

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