What To Do If An Insurance Company Denies Your Claim

When it comes to the world of insurance, there can unfortunately be those moments where an insurance provider will deny a claim you make - regardless of whether it is a legitimate denial or not.

If you believe an insurer has unfairly denied a claim, there are options for you to dispute their decision. However you will need persistence, patience and guidience through the dispute process.

‘No’ does not make it final

Say your business is involved in the trades industry and something happens to interrupt your business - such as a flood, expensive equipment theft, etc. - and you make a claim for some financial assistance to see you through this unknown interruption period. What if your insurer’s answer is no? Does this mean that’s the final verdict? The answer to that question is no.

Just because an insurer says “No” doesn’t mean you should throw in the towel. It’s an unfortunate fact that some insurance companies can refuse your claim on very thin grounds. So now that you know “No” is not the end, where do you go from there?


Get it in writing

If you feel your insurer’s claim denial is unjust or questionable, ask them to provide you with a comprehensively written explanation for their denial. They have to respect this request. When you receive the written explanation, compare it with the policy you agreed to when you signed up with them. Identify any inconsistencies and note them down. If these inconsistencies prove they’re unfairly denying you your claim then confront them about it.

The result will consist of them either now acknowledging your claim or still refusing it.


Get your insurance broker to help you out

If you got your insurance through an insurance brokerage, then one of the advantages this approach yields is that your broker will help you fight for your claim. Insurance companies that are refusing you a rightful claim will try to throw you a few curve balls. With their expertise, a broker will be able to bring more expertise and knowledge into managing your claim on your behalf.


Know your rights

If your insurance provider is still denying your claim at this point, a good idea is to speak to the correct governmental body that knows what you’re entitled to when it comes to insurance. In Australia, it’s the Financial Ombudsman Service. You can speak to them and enquire about whether or not your insurance provider is right or wrong.

If the Ombudsman confirms that you’re in the right and deserve the claim, they will even fight it for you to ensure you get what you deserve.


Final measures

Ultimately the hope is that this is as far as you would have to go, but if you’ve proven to be in the right and you have no other options, you could move to take legal action on the insurance company. This, of course, is a final measure as you will then have to account for legal costs - regardless of if you win or not. Hopefully, though, you will never have to resort to this.


If you’ve ever found yourself in a situation where an insurance company has denied you a claim you had every right to (claim), we’d love to hear about your experience in the comments below.