What does it mean when a claim is denied

Video What does it mean when a claim is denied

check why your insurer denied your claim

Your insurer may refuse to pay your claim because:

  • the policy was not in force when what you claim happened
  • the policy is not valid because you did not tell the truth when you applied for the insurance or you did not disclose something that could affect your claim (for policies contracted, renewed or modified before April 6, 2013 )
  • the policy is not valid because you deliberately or carelessly withheld information or misled your insurers (for policies purchased, renewed or modified after April 6, 2013)
  • the item is not covered by your policy
  • there is an exclusion clause in the policy, which means you cannot claim for what happened
  • you missed some of your premium payments
  • didn’t tell your insurer about a change in your circumstances
  • You have not followed the claim process correctly
  • you have not complied with a condition of your policy
  • You have overstated the claim and are trying to claim more than you should.
  • Your insurer must give you a reason to refuse to pay your claim. check the details of your policy carefully to make sure your decision is reasonable.

    If you think your insurer is not being reasonable in denying your claim, you can try negotiating with them. If you are still not satisfied with how your complaint has been handled, you can make a complaint using their complaint process.

    • more information on when your insurer can reject your claim if you do not provide relevant information, for policies purchased, renewed or modified before April 6, 2013
    • if your business interruption insurer refused to cover your coronavirus losses

      You may be able to challenge their decision. You can check whether your insurance should have covered your coronavirus losses on the website of the financial conduct authority.

      uninsured losses and your deductible

      sometimes a claim will not be covered by your policy. this is called an uninsured loss. For example, a power outage may mean the contents of your freezer need to be disposed of, but your policy may not cover the cost of replacing it.

      If your insurance policy includes a excess, it is also a type of uninsured loss. A deductible is the fixed amount of any claim, for example the first £50, which you must pay yourself.

      If you lose financially and are not insured, but what happened is not your fault, you may be able to take the person or company that caused your loss to court to recover your expenses.

      pay the excess for a car accident that is not your fault

      When you pay the excess for a car accident that is not your fault, you may have to claim this reimbursement from the insurance company of the driver who caused the accident once the claim is settled, if you do not have the expenses covered for pay this for you. If you have trouble getting your money back, you can sue the insurance company or the driver.

      If your insurance company handled the claim, they must claim the excess for you. If you have a no-fault accident, a credit rental company can also make a claim on your behalf.

      • credit rental companies – if the accident was not your fault
      • Your insurer will not pay the full amount

        Your insurer may agree to pay part of your claim, but not the full amount. this may be due to:

        • You have underestimated the full value of your claim and do not have enough insurance to cover your losses. this is called being underinsured
        • Your insurer believes they have put an unrealistic value on your claim and will only pay you a portion
        • Unless you have a new for old policy, the item you are claiming for was old and your insurer will pay you less than the cost of replacing it with a new item. this is because you have already put it to some use
        • there is a limit in your policy on the amount the insurer will pay for any one item
        • you have to pay a deductible
        • deliberately or recklessly withheld information or misled your insurers when you purchased, renewed or changed your policy and the insurer would have charged a higher premium because of this.
        • If you think your insurer is acting unreasonably by refusing to pay the full amount of your claim, you should try to negotiate with them to reach an agreement. If you are not satisfied with what your insurer is offering, you can file a complaint using your insurer’s complaint process.

          other useful information

          • for more information on the financial ombudsman’s approach to dealing with insurance disputes at www.financial-ombudsman.org.uk
          • next steps

            • problems with an insurance claim
            • make a claim on your insurance policy
              • if you need more help
Content Creator Zaid Butt joined Silsala-e-Azeemia in 2004 as student of spirituality. Mr. Zahid Butt is an IT professional, his expertise include “Web/Graphic Designer, GUI, Visualizer and Web Developer” PH: +92-3217244554

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