Insurance claim rejected? Learn the formal complaints process, how to escalate to the Financial Ombudsman Service, and when to seek legal representation.
Why Do Insurers Reject Claims?
Insurance companies reject claims for many reasons — some legitimate, others less so. Common reasons include: alleging you failed to disclose relevant information when taking out the policy, claiming the damage is excluded under the policy terms, arguing you did not take reasonable steps to prevent the loss, or simply valuing your claim far below the true cost of repair or replacement. Understanding the specific reason your insurer has given is the first step to mounting an effective challenge.
Start With the Insurer's Formal Complaints Process
Every UK insurer is required by the Financial Conduct Authority (FCA) to have a formal complaints procedure. Do not settle for a phone call — write a formal complaint letter that includes your policy number, claim reference, a clear explanation of why you believe the decision is wrong, and what you want the insurer to do to put things right. The insurer must acknowledge your complaint promptly and provide a final response within eight weeks. Keep copies of everything.
Escalate to the Financial Ombudsman Service
If you are unhappy with the insurer's final response, or if eight weeks have passed without a satisfactory resolution, you can escalate your complaint to the Financial Ombudsman Service (FOS). The FOS is a free, independent service that resolves disputes between consumers and financial businesses. They will review your case, look at the evidence from both sides, and make a legally binding decision. The FOS has the power to order the insurer to pay your claim, plus compensation for distress and inconvenience. There is no cost to you, and you do not need a solicitor to use the service.
When to Involve a Specialist
For larger or more complex claims — particularly those involving significant property damage, business interruption, or where the insurer is alleging fraud — it is worth involving a specialist early. Loss assessors can independently value your claim and negotiate directly with the insurer on your behalf. Insurance dispute solicitors can challenge unfair policy interpretations and, if necessary, issue court proceedings. The key is to act quickly: there are time limits for bringing legal claims, typically six years from the date of the loss.
Common Mistakes to Avoid
Do not accept the first offer without checking it covers all your losses. Do not throw away damaged items before they have been assessed. Do not start repairs without the insurer's agreement unless there is an immediate safety risk. And most importantly, do not assume the insurer's decision is final — many rejected claims are successfully overturned on appeal or through the FOS. Persistence and good documentation are your strongest tools.
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