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Why might your insurance claim be rejected?

If you submit an insurance claim under your policy, the insurer could say that they’ll not pay you or only pay a portion or all of what you’ve made a claim for. There are many reasons this could occur and a variety of ways you can do about the issue.

What could cause your insurance claim to be denied?

There are a variety of reasons an assertion could be rejected either in fairness or not. A few of them are listed below.

Incorrect information

It is possible that you have provided insufficient or incorrect information in your claim, either deliberately or accidentally. In this case, for example, how something took place or what happened to it.

The insurance company believes that you didn’t use ‘reasonable caution’

Most policies contain a ‘reasonable care or ‘duty of care’ clause which will require you to take the necessary steps to avoid a claim occurring. For instance, if, for example, you have left your valuables out displayed in your car or while on the train, the insurer could consider this to be the reason to challenge your claim.

Inaccuracies or omissions within your insurance application

The insurer may deny an application if the insurer has a reason to believe that you did not take reasonable precautions to answer all questions on your application honestly and in a timely manner. One common instance is failing to declare an existing medical condition.

Technical “sticking points”

Insurance companies may find some inconsistent reasons to dispute your claim. For example, they may challenge whether the item that was stolen or lost was utilized for personal or business purpose. If the latter the item may not be covered under the policy.

The proper claim procedure wasn’t being followed.

Insurers typically expect their clients to follow the law and could make use of evidence that you are not following their claims procedure precisely enough 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 when your insurance policy doesn’t offer enough coverage to cover your losses. You’ll need to pay an extra amount in the event that your insurer thinks you’ve exaggerated the amount of your claim.

If you aren’t satisfied with the reasons offered by the insurance provider for the decision to deny your claim, then you are entitled to lodge a grievance.

What should you do if think your claim shouldn’t been denied

When searching for insurance claim rejected help, make sure you contact the experts at Resolute Claims.

Review the policy documents of your company.

Examine the specifics in your policies to determine whether the information you have provided is in line with your reason for rejecting the policy.

It’s worth challenging the decision in the event that you believe that it was wrongly denied. This is due to the fact that these decisions are sometimes overturned (often when you take the matter into The Financial Ombudsman Service – find out more details about this in the following):

Make sure you have provided all the correct information at the beginning.
Highlight or write down the exact words in your policy which states that you’re covered. This is because you’ll need it later on.
If the language is unclear or unclear, take note of it down. Your insurance company is required to provide you with clear and concise details and must provide an adequate explanation as to why they are refusing to settle your claim.
The new rules say that insurance companies aren’t able to refuse to accept your claim if they did your best to answer all of their questions in a timely manner as well as to your best ability. If your insurance provider didn’t request for details, but they do claim that you should have made it public, so be aware of that as well.
Did the insurer request to provide the information it is now claiming you must have disclosed voluntarily? If not, take an note of it.

You can also look up any other documents related the policy.

If, for instance, you wrote the insurance provider a written note to inform the company of changes in your situation (this is your obligation) You should try to locate an original copy of the letter.

Get in touch with the insurer

After you’ve had a look through your policies, now is the time to contact your insurance provider.

You can call the company to speak with their complaint handlers, or send an official letter of complaint and mail it to the email address provided in the complaints procedure of the company.

The complaint should be processed through the internal review procedure. You may request specifics on this process if you would like to.

If you purchased your insurance via an insurer they could handle your claim for you. It’s worth askingto spare yourself the headache.

How do you write an official complaint letter

Here are some guidelines for writing your letter of complaint:

Place an inscription on your letter.
Name and your policy number.
The letter ‘complaint’ should be placed in bold letters on the top.
Include any evidence that you have to back your complaint.
Tell us what you would like for the business to take action to fix things right.
Be clear in your explanation of your complaint and explain why the claim should not have been denied.
Declare that you’re not satisfied with the company’s response. you’ll refer the matter up with the Financial Ombudsman Service.

Find an independent evaluation

If the issue is a technical issue or a specialist issue It may be beneficial to seek an independent opinion. For instance, if your insurance company claims that the damages to your property occurred caused by wear and tear, and you’re saying it was caused by an accident.

It’s a good idea to get an assessor (not not to be confused with loss adjuster who is employed by the insurer) to assess the damage and provide a statement to an insurance firm for evidence.

You should be aware of the fact that these companies will charge you a fee to represent you.

Even if it doesn’t alter the mind of the insurance company the insurance company, it can be valuable information to be able to refer to later.

Visit the Financial Ombudsman Service

If you’re still not satisfied after having gone through the insurance firm’s complaints procedure, you’ve got 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 take into consideration all sides of the issue, look at the evidence and try to come up with a fair solution that is based on evidence and the commonsense.

You are only able to file an appeal after you’ve received the term “final response from your insurance provider or when eight weeks have been passed but you haven’t received any response from them.

If they determine that your claim was incorrectly denied If they decide that your claim was rejected incorrectly, the Financial Ombudsman Service have the authority to force an insurance firm:

* provide a rationale for its actions

* apologize and

Pay compensation or take the appropriate actions to alter the result.


Make sure you send it along with a copy of your last response from the insurance provider and any other documents to support your claim.