Although the majority of insurance claims are paid to policyholders, it is not uncommon for some to be rejected, especially those relating to the home.
Here we explain why your insurance claim could be turned down, what your options are if this happens and how to minimise the risk of rejection.
Valid reasons for rejection
There are several factors which could lead to your claim being reasonably challenged and which need to be avoided. These include:
Wrong information
Stating wrong or false information either when applying for insurance or making a claim can present major hurdles, so it is vital to be honest and accurate at all stages.
Make sure you disclose all the facts and information you are asked for when taking out a policy and claiming. Exaggerating a claim or not telling the truth to try and get cheaper cover is considered fraud and could result in a criminal conviction.
If an insurer believes you have given false information when taking out a policy whether deliberately or innocently, they may try to alter the terms. This could lead to them retrospectively applying a policy restriction, which means the claim may be rejected even if the insurer has already accepted liability and repair work has begun. Or it could lead to them settling a claim proportionately or cancelling the policy.
Lack of care
Property owners must demonstrate reasonable care of their premises by maintaining them properly. If the damage was clearly preventable then your claim will be rejected.
Incorrect cover
Understanding what your insurance does and doesn’t cover is crucial. Research by the Association of British Insurers (ABI) has revealed that the main reason household claims fail is because the claim value is below the policy excess or the policyholder does not have the right cover.
Your insurance must also cover the right type of property whether that’s residential, buy-to-let or commercial. Reading the small print is essential too - there are likely to be terms and conditions that will need to be met to progress your claim successfully, for example using certain types of locks on exterior doors.
Not following procedures
When making a claim, there are important procedures to follow to avoid it being rejected. These include agreeing the work with your insurer before it is fixed.
Refused claims – next steps and options
Provide evidence
If you feel your claim has been unfairly refused, gather evidence to support your argument before complaining to your insurer.
Highlight any wording in your policy that confirms you are covered as well as any that is poorly explained. You should also find relevant documentation that relates to your policy, such as correspondence confirming a change of address or other circumstances.
If your insurer is claiming you should have disclosed information they didn’t ask for in your original policy, note that too.
Contact a loss assessor
At Sarrani, we often work in partnership with fully qualified and highly skilled loss assessors who can help argue liability and ensure you receive everything you’re entitled to under your policy.
Loss assessors understand the steps that need to be taken to help dispute rejected claims relating to property damage. For example, referencing insurance law that may support your case or sourcing expert reports to help demonstrate that the damage was not caused by wear and tear or a lack of maintenance.
If you do decide to appoint a loss assessor, make sure you check:
They have the required qualifications to be handling your claim: Make sure they are a member of the Chartered Institute of Loss Adjusters.
They are authorised and regulated by the Financial Conduct Authority (FCA) for claim handling: Ask for their FCA reference number and check their status on the FCA register.
They intend to act fairly: They should ensure you receive everything you are entitled to and require under the terms of your policy, but it’s important that they don’t try to encourage you to claim for more. Insurance companies quickly notice when loss assessors try to claim for more than is covered or needed, and your association with an untrustworthy loss assessor could significantly slow down the progress of your claim.
At Sarrani, we would never recommend working with any loss assessor who doesn’t meet all three of the above criteria.
Contact the Ombudsman
If you are not happy with how your insurance company has handled your complaint, you can approach the Financial Ombudsman Service. They will consider all the facts and attempt to reach a fair solution for all parties.
Minimising your risk
A damaged property can cause a lot of stress which can make the claims process feel overwhelming and complex. Appointing a property repairs specialist from the outset can take away that stress and minimise the risk of your claim being rejected.
At Sarrani, we can help to manage the entire claim process for you, including providing an experienced opinion on whether or not your claim is likely to be successful and what will be covered. Working in partnership with a qualified loss assessor, we are able to deal with your insurance company on your behalf to ensure your claim has the best chance of being accepted and you receive the maximum required settlement.
Our experienced surveyors will provide a comprehensive specification of repair works for you or your insurance company to approve, source the necessary skills and trades required for your project and oversee all the work ensuring it is carried out in accordance with the agreed schedule and relevant legislation.
We can also bring in any contractors needed for emergency works – such as leak detection, drying out and/or decontamination – and prepare any reports that may be required to help validate your claim.
For further information on ensuring a successful insurance claim for your property, please contact us on 020 3006 3126 or email our experts at info@sarrani.com.