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Insurance

Insurance claims and policy disputes: rejected claims, exclusions, non-disclosure, settlement value, delays, renewals, home, motor, pet, gadget and medical insurance, with clear complaint and FOS routes.

Reviewed 13 September 2026UK insurance focus

Insurance problems are rarely just "the insurer said no". Start with the exact point of dispute: cover, exclusion, evidence, disclosure, delay, settlement value, pricing or complaint handling.

ConsumerWise separates those questions so you can identify who is responsible, what evidence matters, what the insurer must explain, what remedy is realistic and when the Financial Ombudsman becomes the right external route.

Start here

  • Get the policy schedule and wording for the correct policy year.
  • Get the insurer's reason, relied-on clause and evidence in writing.
  • Keep claim merits separate from complaint-handling failures.
  • For an unresolved eligible regulated complaint, protect the FOS deadline.

Diagnosis

What is the problem?

What happened?What to check first
Your claim has been rejectedStart with Rejected insurance claims, then move to Exclusions or Misrepresentation if that is the actual reason.
The insurer is taking too longUse Claim delays & evidence and demand a clear status/action plan.
The payout is too lowUse Settlements & underpayments and reconstruct the calculation.
The insurer relies on an exclusionUse Policy exclusions and test wording, causation and disclosure.
The insurer says you gave wrong informationUse Misrepresentation & non-disclosure and the CIDRA framework.
The premium/renewal/cancellation is disputedUse Renewals, cancellation & pricing.
The insurer deducted excesses or limitsUse Excesses, deductions & policy limits.
You need to escalate the complaintUse Insurance complaints & FOS and protect the six-month referral deadline.

Core disputes

Claim decisions & settlements

Rejected insurance claimsTurn "claim declined" into a testable decision: cover, evidence, clause, causation and remedy.Policy exclusionsWear and tear, pre-existing conditions, unoccupancy, security terms and other exclusions.Misrepresentation & non-disclosureCIDRA, proposal questions, careless versus deliberate/reckless answers and policy avoidance.Claim delays & evidenceLong investigations, repeated evidence requests, adjusters, engineers and repair-network delays.Settlements & underpaymentsLow cash offers, repair/replacement disputes, valuation and underinsurance.Excesses, deductions & policy limitsFixed excesses, multiple excesses, co-payments, limits, depreciation and average clauses.

Policy lifecycle

Policies, renewal & pricing

Renewals, cancellation & pricingAutomatic renewal, home/motor renewal pricing, cooling-off, fees and premium disputes.Insurance complaints & FOSEight-week complaint framework, six-month FOS deadline, evidence and remedies.

Common products

By insurance type

Home insurance claimsStorm, escape of water, subsidence, gradual damage, repairs, underinsurance and accommodation.Motor claims & vehicle valuationsWrite-offs, market value, repairs, courtesy cars, liability and excesses.Pet insurancePre-existing conditions, condition limits, co-payments, dental cover and premium disputes.Gadget & mobile phone insuranceLoss, theft, damage, proof of ownership, exclusions and replacement-device disputes.Private medical insurancePre-existing conditions, authorisation, provider networks, treatment limits and group cover.Travel insuranceTravel-specific cancellation, medical, baggage, delay and claim-refusal disputes.

Connected routes

Related payment and complaint routes

Some insurance disputes overlap with other ConsumerWise routes, but those routes do different jobs.

ChargebackCard-scheme recovery for an unpaid refund or failed insurance transaction; not a substitute for challenging the insurance claim decision.Section 75Credit-card statutory protection where the insurance purchase itself involved supplier breach/misrepresentation and the statutory conditions are met.Financial Ombudsman ServiceThe main external adjudication route for eligible unresolved regulated insurance disputes.Building evidenceOrganise policy, claim, expert and loss evidence for the complaint.

The rules behind insurance claim handling

FCA ICOBS requires insurers to handle claims promptly and fairly, provide reasonable guidance, not unreasonably reject claims and settle promptly once terms are agreed. Those rules do not guarantee every claim succeeds, but they give a useful framework for testing process and decision quality.

Most individual insurance redress disputes go first through the firm's complaint process and then, where eligible, to FOS. The FCA supervises firms and markets; it does not ordinarily decide whether your individual claim should be paid.

Official sources

Check the current source material.

Use the live policy wording and official source for the relevant policy year. Insurance cover and exclusions vary materially between products.