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How To Make An Insurance Complaint - Oakleafe Claims

HOW TO MAKE AN INSURANCE COMPLAINT
Insurance Advice, Insurance Claims, Insurance Company, Loss Assessor

We all want to believe that the insurance company will act with integrity and treat our claims fairly but if they do not it is essential to know how to make an Insurance Complaint. If for instance, the home repairs ordered by your insurance company were not completed to a satisfactory standard or you have an issue with the automatic renewal of your policy, you may want to make an Insurance Complaint.

There are several steps involved in making make an Insurance Complaint. You can try to work with your insurance company directly to resolve your complaint informally but if that does not work you have to make a formal written complaint. The insurance company must respond to a formal complaint and if you are unhappy with their response, you can take your case to the Financial Ombudsman Services (FOS) or court. Last year the Financial Ombudsman Services found in favour of the consumer in every 1 in 3 complaints they heard.

Making an Insurance Complaint

First, you should try to work with your insurance company directly. To settle a dispute with the insurer informally you can call them and present your objections. Depending on the issue the insurance company could change its mind in your favour without you having to do anything else. However, if you're not happy with the informal resolution the next step is to write a letter as a formal complaint to the insurance company. Ask about your insurance company’s complaint procedures and make sure to make your complaint in writing and retain a copy for your records. Make sure to mark the letter as "complaint" on top and to include your name and policy number.

Explain your complaint in detail and attach any supporting documentation. Retain a copy and keep records of all communication with the insurer. Insurance companies are required by the financial conduct authority (FCA) to have a complaint procedure in place and to respond to complaints within 8 weeks. The insurer's complaint procedures must be followed first as the FOS can only act after they have responded to the initial complaint or when the 8 weeks is up.

Know your Insurance Complaint rights

You can also challenge your insurance company's decision to reject your claim. Be aware of your rights and know your policy. If there is no valid reason to reject your claim, such as lack of coverage, you can make a complaint. If the insurer still stands by its decision, you can take your case to the Financial Ombudsman Services. In these cases, it may be worth to go through your policy and highlight the exact wording that states that you are covered. If you have any correspondence informing your insurer of change of circumstances, such as change of marital status, this could serve as supporting documentation, so make sure to find those. In cases of rejected claims contesting that decision means your case will be considered by someone more senior but first, you must follow the insurance company's review policy.

Common Insurance Complaints

Last year there were over 25,000 travel, home and car insurance complaints filed with the Financial Ombudsman Services (FOS). The reasons for complaints vary but most common were inadequate standard of repairs, automatic renewal of the policy, inaccurate assessment of loss and rejection of claims, most commonly for non-disclosure. In 31% of cases that had complaints the Financial Ombudsman Services (FOS) found in favour of the consumer.

The FOS found that 28% of complaints they heard last year had to do with wording in policies and exclusions which were leading to denials of claims. Non-disclosure disputes accounted for a further 12% of complaints which the Financial Ombudsman Services upheld. In those cases, the insurance company claimed they were misinformed about the claimant’s circumstances, which is why it is so important to keep records of all correspondence to insurance companies.

In these cases, the services of a Loss Assessor such as Oakleafe Claims may be very helpful as they will go over details in your policy in depth and advise you the correct course of action to take. Finally, Loss Assessor’s services may be especially helpful in cases of disputes over the assessment of loss. The insurance company’s objective is to pay the minimum required by law and your claim could potentially be worth much more than that. Even if your insurer offers a settlement you do not have to agree to it straight away if you think that the cost of your damage is more than that it could be helpful to seek advice from a Loss Assessor such as Oakleafe Claims.

Financial Ombudsman Services role in Insurance Complaints

If your insurer does not address the complaint within eight weeks or if you are unsatisfied with their response you can take your complaint to the Financial Ombudsman Services (FOS). The FOS is an independent organization which settles financial disputes and their services are provided at no cost to consumers. You can also take your complaint to court without contacting the FOS or if you are unhappy with their decision but in that case, you will need to contact and hire a solicitor and cover the costs.

The Financial Ombudsman Services (FOS) will look at the facts of your case by considering your side and the insurer's side of the argument. Since this is not a court, you do not have to worry about making a formal argument. Instead, all you must do is present your side in your own words. After hearing both sides, they will either accept your complaint or reject it. If your complaint is upheld by the FOS you will be awarded compensation and they also have the authority to order your insurance company to pay further costs for the inconvenience.

If the Financial Ombudsman Services rejects your complaint, you can still take your case to court. However, it is unlikely that you would win in court if the FOS does not feel you deserve compensation.

Conclusion

Sometimes it is necessary to dispute a claim with an insurance company. For instance, if the insurer denied your claim based on non-disclosure but you have correspondence which you proves that you did inform them of your circumstances you should make an Insurance Complaint. The Financial Ombudsman Services (FOS) is of great help to consumers and finds in their favour in a third of all complaints but you do need to follow your insurance company’s complaint process first before reaching out to the FOS. Taking your case to court is also always a consideration. No matter which way you decide to proceed with your complaint knowing your rights and How to make an Insurance Complaint go a long way towards reaching a favourable outcome.

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