How to deal with an insurance claim

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How to deal with an insurance claim

When making an initial call to your insurer, you need to have read your policy documents before you make the call.  It can be the difference between your claim being processed or being rejected at the outset.  By doing this, you can direct the insurer to the exact policy wording that confirms that you are covered for the incident.

Unfortunately some call centres can at times advise callers that they are not covered (as we have discovered in the past).  You are then forced to complain in writing to the insurer and find that the decision is overturned much later on.

If you find yourself in this position, and you are not sure if you are covered, you need to look at your policy documents first and point out anything that appears to confirm that you are covered to your insurer.

One of our members found that when she originally called the claims line, she was wrongly advised that she was not covered.  This only came to light once she contacted the Financial Ombudsman Service and they upheld her complaint.

*Good tip: If you have a buy to let property, loss of rent should also be covered under your buildings insurance policy.  Check your policy carefully before you make a call.

Follow our guide:

  1. Have your policy documents to hand and read them to make sure that the incident you have suffered is covered under your policy.
  2. Telephone your insurance company’s claims line, have your policy number ready.
  3. Advise the insurer of the time/date of incident.  Do not explain how the incident occurred if you do not know what caused it.  You should never give too much information over the phone if you feel unsure of the circumstances.
  4. If it is an emergency you need to ask the insurer whether you can call out an engineer and that the insurer will cover the cost.
  5. Confirm to the insurer whether you want to use one of their recommended engineers/contractors or whether you want to use your own.
  6. If the property is not in a liveable condition, you need to confirm that to the insurer so that they can help you secure alternative accommodation immediately.

You will need to have the following handy:

  • All paper/email receipts in relation to the claim (including paper/email receipts for emergency works you may have carried out).
  • Paper/email receipts of property damaged or missing.  For guidance with this, click here.

If your insurer accepts the claim:

  • Once the emergency has been dealt with, they may send a surveyor/loss adjustor to your property to assess the claim.  The surveyor may ask you to sign a report.  Do not sign it, you are not legally obliged to sign anything!
  • The insurer may again recommend one of their engineers/contractors to start remedial work. You have the right to choose your own.
  • Do not tackle any works until you have been given the go ahead by the insurer or they may not payout.
  • The insurer will request all email/paper receipts for property damaged or missing.  For guidance with this, click here.

If your insurer rejects the claim:

Write a letter of complaint setting out the following (write it in a story form):

Dear Sir/Madam,

On [day] [month] 201[ ] I contacted your company to advise of an incident in relation to a(n) [loss of water/escape of water] to my property.

You rejected my claim.  I feel that this was unfairly rejected because [fill out why you believe your claim should be upheld.]

I look forward to hearing from you.

Yours sincerely/faithfully

[Your name/Address etc.]

Regardless of whether you have been rejected verbally, you should never take no for an answer.

Your insurer may then send a surveyor/loss adjuster to your property to assess the claim.

Your insurer will then write to you formally outlining their final response.

If you are not happy with it, you can write to the Ombudsman outlining your complaint in detail.  Include all correspondence between you and the insurer. You will also need to give the Ombudsman a copy of your insurance policy document.

For guidance with the following subjects, click on the links for more information:

Loss or escape of water

Storm damage

Burglary

Fire