If you file an insurance claim under your policy, the insurer could say that they’ll not make a payment or only pay a portion or all of what you’ve declared. There are many reasons this could be the case and there are a number of things you can do to deal with the issue.
What could cause your insurance claim to be denied?
There are a variety of reasons claims could be denied either in fairness or not. A few of them are listed below.
Incorrect information
You may have provided incomplete or incorrect details in your claim, either intentionally or accidentally. For instance, what happened or how it occurred or was damaged.
The insurer believes you didn’t exercise’reasonable care’
The majority of policies have a’reasonable care or ‘duty to care’ clause which will require you to take the necessary steps to avoid a claim being made. For example, if , for instance, you put your valuables up for display in your vehicle or while on the train, the insurer could see this as an excuse to deny your claim.
Inaccuracies or omissions 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 care to answer all questions on your application truthfully and in a timely manner. One common instance is failing to reveal any medical condition that was pre-existing.
Technical “sticking points”
Insurance companies may find “small print” reasons to contest your claim. For instance, they may challenge whether an item stolen or lost was used for business or personal purpose. If the latter is the case the item may not be covered under the policy.
The correct claims procedure wasn’t being followed.
Insurance companies often require 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 declining the offer.
The insurer claims it will only pay the amount of the claim.
This could occur, for instance when your insurance policy doesn’t offer enough coverage to fully cover your losses. You’ll need pay an extra amount when the insurance company believes that you’ve exaggerated the amount of your claim.
If you’re unhappy with the reason given by the insurance provider for refusing to pay your claim, you’re entitled to file a complaint.
What do you do if think your claim shouldn’t been denied
Review the policy documents of your company.
Examine 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. For insurance claim rejected help visit this website…
It is worth challenging the decision in the event that you believe that it was not fair to reject it. This is because such decisions are sometimes overturned (often after submitting them to Financial Ombudsman Service – find out more 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 insurance policy that states you’re covered . You’ll require it in the future.
If the language is unclear or unclear, write the wording down. The insurance company has a responsibility to provide clear details and must provide 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 did your best to answer their questions truthfully in your ability. If your insurance company didn’t request information, but they’re now saying that you should have disclosed it in a voluntary manner the information, so note that down as well.
Did the insurance company ask you to provide the information it claims you should have divulged? If not, make the note of this.
You can also look up any other documents related the policy.
For instance, if you wrote the insurance provider a written note to inform that they had changed your situation (this is your obligation) Try to locate an original copy of the letter.
Make contact with your insurance provider
If you’ve looked over your insurance policy now is the time to contact your insurance provider.
Contact the company to speak with their complaints handlers . You can also compose 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 can request specifics on this process if you wish to.
If you purchased your insurance with an agent they may be able to handle your complaint for you. It’s worth askingto spare yourself the headache.
How do you draft an official complaint letter
Here are some helpful suggestions for how to write your letters of complaint:
Place your date of birth on the note.
Please provide your name and the your policy number.
Write the word ‘complaint’ in bold letters on the top.
Include any evidence you can to support your claim.
Write what you want your company’s response to make things right.
Make your complaint clear and explain why your claim shouldn’t be denied.
If you’re not satisfied with the company’s response. You’ll submit the issue up with the Financial Ombudsman Service.
Request an independent assessment
If the issue is a technical issue or a specialist issue or specialized, you may want to seek an independent opinion. For instance, if your insurer claims that the damages to your property occurred due to wear and tear but you’re saying it was an accident that caused the damage.
It’s worth contacting an assessor (not not to be confused with loss adjuster who is employed by the insurer) to evaluate the damages and submit their assessment to insurance companies for evidence.
It is important to know that the company will demand you a cost for representing you.
Even if it doesn’t alter the mind of the insurance company the insurance company, it can be valuable data to keep for later.
Visit the Financial Ombudsman Service
If you’re still unsatisfied after having gone through the complaints procedure, you’ve got the right to bring complaints to Financial Ombudsman Service.
The Financial Ombudsman Service is an independent, non-profit service that investigates complaints made by people about financial firms.
If you submit your complaint directly to the authorities, they’ll take into consideration all sides of the issue, look at the documents and try to reach a fair conclusion using the information and facts.
It is only possible to make a claim after receiving what’s known as a “final response from your insurance provider after eight weeks been passed but you haven’t received an answer from them.
If they determine that your claim was not properly denied The Financial Ombudsman Service have the authority to force an insurance firm:
Define the actions of the company.
apologize for your actions, and
Pay compensation or take the appropriate measures to change the result.
Send it in with the copy of the last answer letter sent by your insurance provider and any other documents that can support your case.
Do I require an “expert to assist me in my problem?
There’s no need for any help or assistance when you have a complaint.
The Financial Ombudsman Service is a informal and free service that would like to hearing from people in the form of your personal words.
Every person has the right to choose someone else to represent them.
A few people may prefer to ask somebody from neighborhood Citizens Advice or a relative or friend assist people with their complaints.
However, if you choose to engage someone else to present your case on your behalf like an agency for claims management then you may need to cover their expenses yourself.
It could be that you pay them a portion of any award you receive.
Copyright Reseau Actu.