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What to do if your insurance claim is turned down

We all know the importance of taking out insurance and we do it in our millions every year - everything from home, car and travel insurance to critical illness and life insurance

We do it in good faith and in return, expect peace of mind and the knowledge that if something goes wrong, we are covered.

Claims rejected - on the rise

Except, sadly, it doesn't always work like that. Not only is there evidence that insurance companies are getting stricter about paying out claims, mainly because of the tough economic climate and fraud, but a growing number in the home, travel and car insurance sectors - 525,000 people between 2013 and 2014 - had their claims rejected.

These figures, from the Association of British Insurers (ABI), show that 378,000 of these were home insurance claims, 104,000 were travel insurance claims while 43,000 were car insurance claims.

There's no doubt, according to the British Insurance Brokers' Association (Biba), that many problems stem from the increasing number of policies sold online, particularly for home insurance, with consumers making a choice based on price and without being fully aware of what the policy does and doesn't cover.

Common reasons for rejection by an insurance company:

These include:

  • Supplying incorrect information - something like being economical with the truth about how something got damaged, for instance;
  • Being careless - leaving valuables on display in your car or not having locks on your windows at home;
  • Not taking enough care to answer all the questions on the form truthfully or accurately - for example, carelessly answered questions on the subjects of smoking and alcohol consumption have caused the rejection of many life insurance policies.

What to do if you feel your claim has been unfairly rejected:

Firstly, get all your documentation together, including any letters you sent to the insurance company and then:

  • Check all the information you gave was correct;
  • Find the exact wording that shows you are covered;
  • Note down anything ambiguous you think might affect your claim;
  • Note down anything your insurance company didn't ask for in the first place which it now says you should have told them about.

If, after writing to your insurance company directly and going through its complaints procedures, you are still unhappy with the outcome you have the right to take your complaint to the Financial Ombudsman.

Between April 2015 and March 2016, it investigated thousands of complaints from consumers including 204 in relation to critical illness insurance, upholding 43; more than 13,500 in relation to payment protection insurance, upholding almost 9,000 and 114 complaints about personal accident insurance, upholding 38.

Expertise at Wards Solicitors

Sometimes, legal help is the only way to make sure you have the expertise you need to pursue your claim.

Partner, James Taylor, Wards Solicitors' financial services disputes specialist, has a proven track record of taking on large organisations, including insurance companies, on behalf of his clients and a reputation for doggedly fighting their corner.

He has acted for a couple who, after a diagnosis of thyroid cancer, had their claim on a critical illness policy refused. Although the Financial Ombudsman Service had found against them after a two year investigation, James re-examined the case, identified weaknesses in the insurer's position, threatened litigation and secured a six figure out of court settlement plus costs from the insurer.

He also advised on a failure to pay claim on a car policy following the loss of vehicle and a failure to pay claim on a life policy for non-disclosure of a medical condition.

James says: "Litigation is a minefield but, if you involve an expert at the outset, the paths through it lead to resolution. Speaking to a solicitor avoids costly mistakes, the case being sidetracked down blind alleys and ensures you're taken seriously. We can deliver outcomes that you might never have considered, maximise your chances of success by putting the case properly and succinctly, and ensure that you don't bury the good bits under piles of bad. In short, we work to achieve resolution in a cost-effective way."

If you need help and advice about a rejected insurance claim, please contact James Taylor who deals with financial services disputes at Wards Solicitors.

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