Making an insurance claim, particularly if large sums are involved, can be stressful, but there are steps you can take which may make the process easier.
Still, when you’re already preoccupied dealing with the aftermath of whatever it is you’re claiming for, whether that’s a burglary, a car accident or something else, the last thing you want to be doing is dealing with a load of questions from your insurer.
That’s why we’ve put together this simple guide to making an insurance claim, including a section on what to do if your claim is rejected.
Keep your documents safe
As soon as you’ve bought an insurance policy, the biggest favour you can do for your future self is to make sure you know exactly where the relevant documents are, so that you have your insurer’s details to hand if something goes wrong. If you have physical copies of the policy documents, put these in a clearly marked folder. If you have digital files, save them to your computer and print out copies – it could even be worth putting them onto a USB stick as well.
If you have insurance for possessions, such as contents or vehicle cover, it would be wise to store copies of receipts for any valuable items in the same place. You could also keep photographs showing them in their current condition.
Something’s happened - what to do first
If an incident has occurred and you need to claim on your insurance, first try to think whether there is any action that needs to be taken beforehand and contact your insurer for advice. For example, if your car has been stolen or vandalised, or your property has been broken into, you should report this to the police immediately. Besides being the sensible thing to do, this is often a requirement for you to be able to make a claim on your policy. Keep the reference numbers from any reports you file to hand for your insurance claim application.
If there is anything else you can document from the incident, do so. This could be photos or videos of a shabby hotel room, flight numbers for delayed or cancelled departures, lists of lost or stolen items, contact details for anyone who might have witnessed what happened, and so on.
Check your policy to see if it covers the incident
Before you go ahead and submit your claim, check your policy documents to ensure that whatever happened is covered and you’ve done everything you need to do.
There can often be frustrating exceptions present in your policy – your vehicle insurance might not cover certain kinds of accidents, for instance, or your travel insurance might only compensate you for cancelled plans under particular circumstances. Try to avoid these unpleasant surprises by checking the policy small print carefully before you buy.
Sometimes there may be a specific procedure you need to follow. For example, if a pipe bursts in your home and you want your insurance to cover the plumber that you call to fix it, it might have to be one approved by your insurer.
Get the facts straight
Before you make your claim you should make sure you have your story straight, with as many details as possible – write it down if it helps. This will likely speed up your claim getting processed.
Make sure you know:
- Exactly what happened
- All relevant times and dates
- The details of everyone involved (such as other parties in a car crash, or anyone you had to call to make emergency repairs)
- How much you’re claiming.
This is also the point where you should make sure you have all of your documentation together.
Making your claim
To make a claim, either call your provider’s helpline (usually listed on your policy and their website) or see if they have a document online for you to fill out. Have all of the details and paperwork from the previous steps to hand. Make a note of when you make your claim, who you speak to and what information you’ve given in case it comes up later.
Be as honest as possible in the application process. Give the details clearly and don’t exaggerate. If your provider finds out you’ve been dishonest, this will be considered fraud and you will likely have your claim rejected. The incident may also be recorded so that other providers are aware of it, which will make it much more difficult to obtain cover in the future.
Try to leave as little time as possible between the incident and making the claim. You’ll likely be under a lot of stress as a result of whatever’s happened, and it might take a moment to get your head together and gather everything you need, but don’t leave it too long if you can avoid it. Your policy may have a time limit, and the information will probably be fresher in your mind the sooner you claim (not to mention it’ll feel better to have it out of the way).
If you consulted with an adviser or bought a policy through an insurance broker, they may be able to help you make your claim. Give them a ring, as they will often be able to offer you advice, work with your provider and sometimes even get most of the work done for you.
Some policies work differently...
Making a claim for life insurance, critical illness cover, income protection or private health cover can work a bit differently to making a claim on your home, car or travel insurance.
With private health insurance, you’ll usually need to obtain a referral from your GP for a private doctor. Once you’ve been referred, you should contact your provider with details about your diagnosis, treatment and referral in order to make a claim and get the treatment approved.
With life insurance, critical illness cover or income protection you should call the provider first (with the relevant documents) to find out what the procedure is before making your claim. With life insurance, of course, you will be claiming on a policy bought by someone else, so make sure you know who the provider is for people very close to you, such as your partner, and that you have copies of all the relevant documents. Likewise, if you have bought a policy yourself, it makes sense to ensure that your beneficiaries have everything they need to make a claim.
If you’re in search of a life insurance policy, we’ve partnered with life insurance expert Teddy Cenaj to offer fee-free advice to our members. All you need to do is book a no-obligation call to get personalised fee-free advice and quotes from the whole market.
What should I do if my insurance claim gets rejected?
If your claim has been rejected and you feel as though it shouldn’t have been, you can take action to dispute your insurer’s decision. This can require taking the matter to the Financial Ombudsman Service if things escalate that far.
Check your documents
If you can’t understand why your claim has been refused, start by checking your policy and the information you submitted. Make sure you gave the right information and highlight any wording in the policy that you think entitles you to a payout (as well as any wording that is vague – your insurer is obligated to be clear). If they have rejected you because of missing information that they forgot to ask you for, note that down.
Find any other relevant documentation as well – if you previously contacted your provider to let them know about a change in your circumstances, for example, try to find evidence of this.
Contact your provider
After making these checks, get in touch with your provider and see what their complaints process is. If you bought your policy through a broker, they might be able to help with this bit or do it for you.
If you are writing a letter of complaint, state clearly why you think your claim should not have been rejected, include any evidence you have to support your case, and outline what you would like them to do to put things right. Make sure to include your name, policy number and mark the letter “Complaint” clearly at the top. Make it clear that you will go to the Ombudsman if the matter isn’t resolved. Find out more about making a complaint in our guide How to complain about a financial company.
Get an independent assessment
In certain cases, it might help to get an independent assessment of the situation. For example, if you and your insurer disagree on why something is faulty or broken, a specialist might be able to settle the dispute.
If you disagree on something like the cost of damage to your car, you can hire a loss assessor (not to be confused with a loss adjuster, who works for the insurance company) to look at the damage and send a report to your provider with their figure (you’ll have to pay them for this service, of course).
Go to the Ombudsman Financial Service
If you have received a “final response” from your provider that they refuse to settle your claim, or you’ve gone eight weeks without hearing from them, you can take your complaint to the Financial Ombudsman Service. This is an independent, fee-free body that investigates complaints about financial companies. You can take your case to the Ombudsman here.
The Ombudsman will assess the situation, taking all evidence into account, and come up with a final, impartial, decision. If they take your side, they can make your provider apologise, explain its actions and pay compensation or do whatever needs to be done to put things right.
Avoid being double-insured
Before buying a policy, make sure that you’re not already covered for that particular type of insurance. This may sound obvious, but there are a few ways you might have insurance and not even be aware of it.
For example, you might have an insurance policy packaged with your bank account or credit card. If you were to buy another policy on top of this and become “double-insured” then claiming would be much more complex – each insurer would only have to pay a certain share of the total amount, even if you had been paying full premiums to one or both of them.
Alternatively, you might have some kind of income protection included with your work benefits package. Check your contract carefully and read our guide Am I protected financially? to make sure that you’re not about to buy a policy that you don’t actually need.
Have you recently made an insurance claim and did you find the process difficult or straightforward? Either way, we’d be interested in hearing from you. You can join the money conversation on the Rest Less community or leave a comment below.