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Insurance company not covering claim
If something has gone wrong, then you will be relieved if you took out insurance to protect you against the risk.
However you and the insurance company may have different views about whether the event was covered by the insurance. Also you may not agree on what is a fair payment.
The law expects both you and the insurer to have acted reasonably. If the insurer will not fully cover your claim you may have to take legal action against them. However the first step is a written complaint letter. Some insurers will then be prepared to consider mediation.
For disputes of £10,000 or less our small claims service should be able to help you. To get started here is a summary of the law and a sample complaint letter.
| Your rights |
The insurance policy is an agreement or contract between you and the insurance company. Your right is for the insurer to act reasonably and pay what you are entitled to.
The wording of your insurance policy is the starting point of your rights – it states what you are entitled to receive from the insurance company:
1: Has an event occurred that is covered by the policy? Examples include a theft, a fire or an accident.
2: Have you complied with any requirements under the policy? There will often be requirements that you take certain steps to look after the insured item.
3: How much does the insurer have to pay out?
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| What do you have to prove to bring a claim? |
1: That you have an insurance agreement with the insurer that covers the event. The insurer will tell you if they dispute that an event was covered.
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| What can you claim? | The amount you can claim will be what is “reasonable” in accordance with the rules of the policy |
| What is the deadline for starting a claim at court? | The policy will set the time within which you must report the event that you are claiming for. It will also set how you notify the claim to the insurer. If you and the insurer cannot agree on what they should do or pay you under the policy then you usually have 6 years from the event to start court proceedings for the court to decide if the insurer has “breached the insurance contract” and what is reasonable in the circumstances. |
| Example claims |
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Insurance company not covering claim
If something has gone wrong, then you will be relieved if you took out insurance to protect you against the risk.