Insurance problems can begin at very different points. A claim may be delayed, rejected or underpaid. The insurer may rely on an exclusion, an expert report, alleged non-disclosure or a fraud concern. Or the problem may be with the policy itself: renewal, pricing, cancellation or what was sold.
This hub is organised around what has happened to you, not around insurance-industry terminology. Start with the problem you recognise, then move into the deeper guide if you need to challenge the reasoning or escalate.
The four things to keep together
- The correct policy schedule, wording and endorsements for the relevant policy year.
- The insurer’s current decision, reason and policy clause in writing.
- The evidence relied upon by both sides, including technical reports where relevant.
- A short chronology showing claim events, evidence requests, decisions and complaint dates.
Start with what happened
Which problem are you dealing with?
I am making a claim nowNotify it clearly, preserve evidence and create a usable claim record from day one.
My claim was rejectedUse Steve Smart’s expert guide to test the refusal and build a structured challenge.
The insurer is taking too longRepeated evidence requests, inspections, repair delays or a claim stuck without a decision.
The payout is too lowCash settlements, valuation disputes, deductions, underinsurance and replacement arguments.
The insurer says an exclusion appliesTest the wording, definitions, evidence and cause of loss.
They say I gave wrong informationMisrepresentation, non-disclosure, policy avoidance and proportionate remedies.
They are alleging fraud or dishonestyGet the allegation clear, preserve evidence and understand the possible consequences.
I need to make a formal complaintTurn the dispute into a focused decision, error, evidence and remedy.
Claim journey
Where are you in the process?
| Stage | What matters now | Best starting guide |
|---|---|---|
| 1. Before / at notification | Correct policy, factual notification, evidence preservation | Making an insurance claim |
| 2. Investigation | Evidence requests, adjusters, engineers, records and progress | Loss adjusters & expert reports |
| 3. Decision | What the insurer decided, the clause, evidence and reasoning | Understand the rejection letter |
| 4. Challenge | Causation, exclusions, misrepresentation, settlement or factual error | Rejected claim expert guide |
| 5. Formal complaint | Define the error and remedy; start the complaint route clearly | Complaint & rebuttal |
| 6. External escalation | Final response, FOS eligibility, evidence and deadline | Insurance complaints & FOS |
Expert guide
Insurance claim rejected? Start with the decision.
Insurance claims expert Steve Smart has written a practical ConsumerWise guide showing how to break down a refusal, test the policy wording and evidence, build a focused rebuttal and prepare for the Financial Ombudsman if the insurer does not change its position.
Understand the policy
What does the contract actually say?
Understanding policy wordingSchedule, wording, endorsements, definitions, cover, conditions and exclusions.
Policy exclusionsWear and tear, pre-existing conditions, unoccupancy, security terms and other exclusions.
Misrepresentation & non-disclosureQuestions, reasonable care, careless answers and deliberate or reckless misrepresentation.
Insurance sales, brokers & mis-sellingUnsuitable cover, misleading statements, comparison sites, add-ons and responsibility for the sale.
Renewals, cancellation & pricingAutomatic renewal, premium changes, cooling-off, fees and ending cover.
Excesses, deductions & policy limitsMultiple excesses, co-payments, item limits, depreciation and underinsurance.
Evidence & investigation
Build the evidence around the real issue
Loss adjusters, engineers & expert reportsUnderstand the technical evidence and test assumptions, observations and causation.
Claim records & subject access requestsUse the right route for call recordings, notes, reports and personal data.
Claim delays & evidence requestsWhen investigation becomes drift, repeated requests become disproportionate or progress stalls.
Causation, wear & tearSeparate the insured event from background deterioration and identify the actual cause of loss.
Fraud & dishonesty investigationsHigh-stakes allegations, inconsistent evidence and when specialist advice is sensible.
Building evidenceConsumerWise’s general guide to organising records, documents and proof.
Decision & outcome
Challenge the insurer’s conclusion
Understand the rejection letterReduce the refusal to the fact, clause, evidence and reasoning that actually decide the claim.
Rejected insurance claimsSteve Smart’s expert framework for taking the refusal through evidence, rebuttal and escalation.
Settlements & underpaymentsLow offers, cash settlements, valuation evidence, replacement disputes and underinsurance.
Insurer-appointed repairs & contractorsIncomplete works, poor workmanship, repair-network delay and cash-settlement switches.
Deductions & policy limitsReconstruct the gross-to-net calculation and test each deduction against the policy.
Formal complaint & rebuttalTurn the dispute into a concise case with a defined remedy.
By insurance type
Product-specific guides
Home insurance claimsStorm, escape of water, accidental damage, subsidence, repairs and alternative accommodation.
Motor claims & vehicle valuationsTotal loss, market value, repairs, courtesy cars, liability, salvage and engineer reports.
Travel insuranceMedical declarations, cancellation, curtailment, baggage and travel-claim disputes.
Pet insurancePre-existing and related conditions, annual limits, co-payments, premiums and veterinary claims.
Gadget & mobile phone insuranceTheft, loss, accidental damage, unattended property and replacement disputes.
Private medical insurancePre-existing conditions, authorisation, networks, treatment limits and ongoing care.
Complaint & escalation
When the claim does not resolve
Write the formal complaintIdentify the decision, error, evidence and remedy and make clear that the regulated complaint has started.Insurance complaints & FOSEight-week complaint framework, final responses, FOS evidence, time limits and remedies.Financial Ombudsman ServiceUnderstand the wider FOS role, jurisdiction and decision process.Build a complaint chronologyTurn months of claim activity into a short sequence that a decision-maker can follow.
Some cases need specialist advice sooner.
Consider legal advice where there are serious fraud allegations, very high financial stakes, complex multi-party issues or a court limitation deadline may be approaching. A complaint or Ombudsman route does not automatically protect a court deadline.
Official starting points
Current insurance rules and escalation.
- FCA Handbook: ICOBS 8 claims handling
- FCA Handbook: DISP complaint time limits
- Financial Ombudsman Service: insurance complaints
- Consumer Insurance (Disclosure and Representations) Act 2012
ConsumerWise checked these official sources on 7 October 2026. Policy wording and product-specific rules can differ, so use the documents for the relevant policy year.