Menu
Menu
In the intricate realm of insurance policies and the claims they are designed to cover, there's an eyebrow-raising statistic that every policyholder should be privy to 1 in 5 insurance claims are repudiated, that is, rejected by the insurer.
Simply put, an insurance company can reject an insurance claim by deciding not to honour the claim, often citing various reasons. These could range from non-disclosure of pertinent information to breaches of policy conditions to alleged fraudulent activity. The process leading up to this point can be fraught with misunderstanding and contention, culminating in a scenario no policyholder wants to encounter.
The revelation that a startling 20% of insurance claims are denied may seem surprising, but these figures are not pulled from thin air. An annual report published by the UK's Financial Ombudsman Service in 2021 found that they upheld approximately 1 in 5 complaints about insurance claims being turned down. To shed some light on the magnitude of the situation, consider this: millions of insurance claims are filed in the UK each year across various sectors. A fifth of these claims being turned down indicates a considerable volume of denied claims.
Consider the case of Jane (name changed for confidentiality), a proud homeowner in London. Jane had dutifully paid her home insurance premiums for several years. However, when an unexpected fire caused extensive damage to her home, she was shocked to discover her insurer had rejected her claim.
The insurance company argued that Jane had failed to disclose an essential piece of information when taking out her policy — a small, inconspicuous detail about the electrical wiring of her home. According to the insurer, this represented a material non-disclosure, a basis for Repudiation, meaning her claim was rejected.
Jane disputed this decision, arguing that she had been unaware of the significance of the information and that she had answered all the insurer's questions to the best of her ability when purchasing the policy. Eventually, Jane's contacted us here at Oakleafe, and we took over managing her Claim. We challenged the Insurers and re-presented her Claim, resulting in her receiving the settlement she was entitled to.
Jane's experience underscores the importance of full disclosure when purchasing an insurance policy, but it also serves as a potent reminder of the considerable proportion of claims that insurers deny. The statistic — 1 in 5 insurance claims repudiated — should encourage policyholders to arm themselves with as much knowledge as possible about their insurance policies. Understanding the ins and outs of your policy can be a decisive factor in whether a claim is paid or repudiated.
If your insurance company decide to repudiate meaning your claim is rejected, it's essential first to understand why. Review the insurance policy's terms and conditions to ensure the claim is valid based on your coverage. If you believe the claim was wrongly denied, gather all relevant documents, including reports, repair estimates, or any other evidence supporting your claim. Contact your insurance provider for a detailed explanation of the denial and consider seeking advice from an insurance professional such as Oakleafe Claims. While the thought of having a claim rejected may seem daunting, knowledge and understanding of insurance terms and conditions can go a long way in ensuring the policy serves its purpose when needed. Given the present climate, insurers and policyholders need to work towards a transparent and fair insurance claim process to decrease the number of repudiated claims.
Remember, insurance is intended to serve as a safety net, a lifeline in our times of need. Let's ensure it remains that way. If you have been affected by repudiation, contact us, and one of our highly trained team will be in touch to talk about your current situation.
Insurance Claims, What Should I Do? FAQ. The very first thing you need to do is to engage a Loss Assessor. It is your responsibility to mitigate any damage and prevent it from spreading. Insurance Loss Assessors have vast experience in Insurance Claims Management and are able to handle all aspects of the claim including all communications with the Insurance Company. They would endeavour to get everything you are entitled to and take away the stress. They would help you notify the Insurance Company who would then send a Loss Adjuster to view and inspect the Incident. A Loss Assessor would be there for you every step of the way.
What is a Loss Adjuster and what do they do?
Insurance Loss Adjusters are the opposite of a Loss Assessor, they sent by Insurance Companies. It might seem like they are trying to help but in fact they are employed and paid for by the Insurance Companies. They are there to analyse and investigate the incident and often hire additional 3rd party investigators to determine the cause. Their number one priority is to find ways to limit or even refuse the pay-out settlement known as “repudiation”.
How much can I Claim?
This is strictly dependent on the amount of damage which occurred and the policy that you are covered for. Insurance Companies create big large policies full of many different pages trying to cover up or make certain information hard to find. A Loss Assessor can go through the entire policy and analyse the best possible approach to your Insurance Claim.
What is Liability?
Liability is the legal responsibility or obligation for a company’s action. During a claim an Insurance Company would investigation and determine the cause of the incident. Different actions can be taken depending on the result which can be complicated, but Liability must be accepted before a claim can proceed to the next stage.
How long will my claim take?
Every claim is unique and different in its own sense. The range of complexity can vary from claim to claim especially when dealing with a Business Claim which can lead to Business Interruption. Business Interruption is the process of analysing and calculating financial forecasting of a Business where it would be missing out on if the Loss would not have occurred.
How do you evaluate damage or Loss?
Depending on the type of damage or loss, Insurance Loss Assessors would engage additional specialists to help analyse and assess the loss such as: Chartered Surveyors to inspect property damage, Cyber Security Experts to analyse IT infrastructure and Business Specialists to view sale figures and financial forecasting.
Who pays the settlement?
After liability has been accepted and the final report has been sent to the Insurance Company. It is often agreed between yourself and the Loss Assessor for a small feel for the Claims Handling Service. Remember that an Insurance Loss Assessor is likely to get you 30% more when what your Insurance Company would have offered you making their service vital in getting everything you are entitled to.
If you have been declined whilst trying to claim on your domestic or commercial insurance, we can help. We can also help with professional services, for example, Brokers, VAR Valuations and Managing Agents.
