What to do if your home insurance claim is rejected

You’ve submitted a claim to your home insurance provider, but they’ve told you that your claim has been denied. It’s just the kind of stress you really don’t need right now. Why has this happened? And what now? We investigate.

You’ve submitted a claim to your home insurance provider, but they’ve told you that your claim has been denied. It’s just the kind of stress you really don’t need right now. Why has this happened? And what now? We investigate.

Chris King
Home insurance expert
minute read
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Posted 1 DECEMBER 2020

Why has my home insurance claim been denied?

There are many reasons why a claim could be rejected by your home insurance provider. They include:

  • Lack of cover – one of the most common reasons for denying a pay-out is that you’ve tried to claim for something that’s not actually covered by your policy, for example: wine spilt on the carpet. Accidental damage  is not included as standard, nor is your dog tearing up the sofa.
  • Wear and tear – home insurance policies say that you need to keep your property ‘well maintained’. If, for example, you make a claim for a roof tile that became dislodged during a storm, your insurance provider may find that the problem occurred because you failed to look after your roof properly, rather than it being damaged by the weather.
  • Incorrect information – putting down inaccurate information on your claims form could see it rejected. An example is 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, some of your home’s contents being stolen because you forgot to lock your door.
  • 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 job or getting married.
  • Too late with the claim – 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 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.

Law of averages

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.

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 more to get it covered.

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

While it’s understandable to feel anger and frustration towards your provider, it’s best to take a calm, measured approach to complaining if 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 unique 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

Be sure to proofread your letter multiple times before sending, making sure you haven’t left out anything important.

If you talk to your insurance provider on the phone, 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, if 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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