How long do I have to appeal a rejected insurance claim?

If you want to appeal, you should contact your insurer as soon as possible. If you make a complaint, your insurer must reply (in writing) letting you know they’ve received it. They then have eight weeks to consider your complaint and must provide you with an outcome in that time (they can also ask for additional time). If you don’t get a response within the eight weeks or wish to take the matter further, you can contact the Financial Ombudsman Service. Legally, you have up to six years to report a problem with financial products or services (including insurance). If you discover an issue after this time, you have three years to report it, starting from the date you find the problem.

Can I get professional help with my appeal?

If you purchased your policy from an insurance broker, they may have a claims team that manages claims and the appeal process on your behalf (as we do at Alan Boswell Group). Making an appeal or complaint yourself is free and relatively easy – just follow your insurer’s procedure. But if you’d prefer to hire someone else, then you could consider a claims management company (CMC) to work on your behalf. CMCs will charge you for their service (this is often a percentage of your compensation). The FCA caps CMC fees, so check you’re not being overcharged on the FCA website.

Will a rejected claim make it harder to get home insurance in the future?

A rejected claim can make it more difficult to find home insurance, but it will often depend on why your claim was rejected. For example, people who misrepresent their needs may have more difficulty compared to those who simply weren’t covered for a particular incident.

What is the difference between 'wear and tear' and 'accidental damage'?

Wear and tear is typically used to describe the normal ageing of your home or contents. For example, a carpet that becomes worn or develops holes through heavy use over a long period of time. Accidental damage is usually a sudden and unexpected incident, like a ball breaking a window (unintentionally).

What to do if your home insurance claim is rejected

If you’ve ever experienced the frustration of having a home insurance claim rejected, misunderstanding and confusion are key reasons for unsuccessful claims, so it’s vital to ensure your house insurance policy is tailored to your property and that you’re confident about what is and isn’t covered. But, if you’ve made an unsuccessful claim and think the decision is unfair, you’re entitled to challenge it with your insurer.

We look at common reasons why home insurance claims are declined, what to do if your claim is rejected, and how you can minimise the risk of a rejected claim in the future.

Common reasons why home insurance claims are rejected

In the UK, insurance is a regulated industry. This means that insurers must follow strict rules that ensure fair practice. Under Financial Conduct Authority (FCA) rules, insurers and brokers are expected to handle the insurance claims process fairly and must not unreasonably reject a claim. They must also manage and settle claims as quickly as is reasonably possible.

If your claim is rejected, common reasons for this include:

Non-disclosure or misrepresentation

Non-disclosure means you haven’t told your insurer about something relevant when asked, while misrepresentation means you’ve provided inaccurate or incomplete information. Examples of non-disclosure and misrepresentation could include running a business from your home, having a lodger move in, or not telling your insurer about a previous claim.

If this happens, your insurer could argue that had they known the facts, the policy would have been different to reflect the actual risk; for example, your premium may have been higher. In extreme cases, the insurer could argue that they wouldn’t have provided cover at all and cancel your policy.

Being underinsured

Underinsurance is when the amount you’re insured for (the sum insured) isn’t enough to cover the cost of rebuilding your home or replacing its contents. If you make a claim, it would be up to you to cover the difference in cost.

However, being underinsured isn’t always as straightforward as getting slightly less money. Insurers typically work to a calculation known as the ‘average clause’, which could lead to an even smaller payout.

The average clause means your insurer can reduce your claim payout by the amount you’re underinsured by. For example, if you’ve insured your home for £200,000, but it costs £400,000 to rebuild, then you’re underinsured by 50%. Any payout you receive can also be reduced by 50% (even if you’ve claimed less than the total sum insured). So, if you make a claim for £100,000, your insurer can reduce that payout by 50%, giving you just £50,000.

Many home insurance policies have a blanket sum insured, for example, up to £500,000 or £1million, to help policyholders avoid being underinsured. Our in-depth guide explains more about what happens if you’re underinsured.

The cause of the damage is not covered by your policy

Insurance policies only cover specific incidents (called ‘perils’). Incidents and events that you aren’t covered for will be listed on your policy documents as ‘exclusions’.

Almost all policies have exclusions, which typically include wear and tear and damage resulting from lack of maintenance. For example, if water damage is caused by blocked gutters, your insurer may refuse to pay out on the grounds of poor maintenance. Your insurer may also reject claims due to negligence, for example, if someone entered your home through an unlocked door and stole valuables.

Insurers expect you to take reasonable precautions to prevent loss or further damage in a claim situation. For example, if you claim for storm damage to your roof, your insurer is likely to pay for the repair to the roof (providing it had been well maintained). However, if you didn’t take steps to prevent the damage to your roof causing damage to your belongings, your insurer is unlikely to pay to repair or replace those belongings.

Your policy documents should clearly outline the exclusions, but if you’re unsure, ask your broker or insurer to clarify them for you.

Failure to meet policy conditions

As well as exclusions, your policy may also have a set of conditions that you’re expected to meet. This could include having a specific type of lock fitted or installing a burglar alarm. Not meeting these conditions invalidates your policy and could lead to a rejected claim.

Most insurers will also have a clause about how long you have to report an incident; for example, you might be given up to six months to make a claim, and if you claim outside of this window, they may reject your claim. Most insurers will encourage you to make a claim as soon as possible after an event, but double-check the terms and conditions to be sure of the timescales that apply.

It’s also worth noting that standard home insurance policies typically do not provide cover if your home will be empty for an extended period – usually 30 consecutive days or more. So, if you’re going to be away from home for more than a month, remember to let your insurer know. In this case, you may need to take out an unoccupied home insurance policy to cover your needs.

Your policy has a waiting period

A few home insurance policies have a waiting or exclusion period, sometimes applied at the start of a new policy. During this period, you won’t be able to make a claim. It’s more common in short-term home insurance policies rather than standard annual cover, but it’s something to be aware of just in case (particularly if you’re moving from one insurer to another).

Exclusion periods help insurers minimise fraud and avoid people taking out policies with the intention of making an immediate claim.

Failure to provide sufficient evidence

Insurers will normally require you to retain the damaged item or evidence of the damage (images) for inspection before any permanent repairs are carried out. Failure to do this could result in your claim being rejected.

In conjunction with this, if you proceed with works to permanently repair or replace the damage before getting approval from your insurer, they may reject your claim and refuse to reimburse you for part or all of the works you have paid for.

A step-by-step guide to appealing a rejected claim

If your home insurance claim is rejected and you feel the decision is unfair, you can appeal to your insurer or broker.

You can appeal using the following steps:

Request a final decision in writing

Your insurer must tell you why they rejected your claim. Ask them to put this in writing and to reference the exact wording used in your policy that they’ve used as the basis for their decision.

Review your policy and gather your evidence

Review the section of the policy your insurer has quoted in their final decision letter, and double-check that the terms and conditions match up with this. If there are any contradictions or ambiguities, note them and gather any additional evidence that supports your appeal.

Evidence can include correspondence between you and your insurer, photos, and written assessments by professionals, such as a plumber or surveyor. If calls are recorded, you can also ask for a transcript or an audio copy.

Make your appeal

If your insurer has an appeals process, you should follow this according to their guidelines. Clearly explain why you disagree with the rejection decision and provide your supporting evidence.

Make a formal complaint

If your insurer still rejects your claim despite your appeal and your supporting evidence, you can file a complaint. When you do this, don’t forget to include your policy number and your evidence.

Escalate your complaint to the Financial Ombudsman Service

If you’ve made a complaint, your insurer must give you a decision within eight weeks. If they don’t, or you’re unhappy with your insurer’s customer service and think your claim and appeal have been poorly managed, you can take your complaint to the Financial Ombudsman Service. The service is free and impartial, but you’ll need to do this within six months of your insurer’s response. The ombudsman will investigate your claim on your behalf; if they agree with you, your insurer must settle your claim.

How to reduce the risk of a claim being rejected

Minimising the risk of a claim being rejected should always be the priority. Here are some practical tips to avoid future disappointment:

Be accurate and upfront – answer questions honestly and to the best of your knowledge. If you’re unsure about something, say so. Your broker or insurer will be able to ask questions to help clarify your circumstances and ensure you get the right policy for your needs.

Calculate your sums insured correctly – the sum insured is the maximum amount of money your residential property policy pays out if you make a claim. Use online calculators or hire professional valuers to lower the risk of being underinsured. If you have a policy with a blanket sum insured, you must still make sure it is sufficient to cover the rebuild cost of your property.

Read your policy documents – be clear about what your policy covers, what exclusions there are, and don’t forget to check the terms and conditions so you know what your responsibilities are.

Keep your insurer updated – let them know about any significant changes, for example, building work or running a business from home.

Maintain your property – keep up with maintenance and repairs to prevent leaks, damp and rot, particularly before winter sets in and the risk of storms and bad weather increases.

Home insurance that supports your needs

Shopping around for home insurance can be stressful and time-consuming. At Alan Boswell Group, we know that no two homes are the same, which is why we tailor policies to suit your home and your needs.

As well as buildings and contents cover, we can also provide accidental damage insurance and alternative accommodation if you can’t stay at home after making a claim. For added protection, we offer personal belongings insurance for when you’re out and about and family legal cover for disputes.

Need help with your insurance?

For more information on how we can support you and protect your home, speak to a member of our team.

Speak to us: 01603 649650

What to do if your home insurance claim is rejected

In this article

In this article