Home Insurance: Ombudsmen To The Rescue

If you're unhappy with how your home insurance claim has been handled, you can complain to the Financial Ombudsman Service (FOS). The FOS is a free, independent service that aims to settle disputes between consumers and financial businesses, including insurance companies. Before taking your complaint to the FOS, you should first contact your insurance company and give them the opportunity to resolve the issue. If you're not satisfied with their response, you can then make a formal complaint to your insurer. If this doesn't resolve the problem, or if your insurer doesn't respond within eight weeks, you can then take your complaint to the FOS. The FOS has the power to award up to £415,000 against an insurance company. However, it's important to note that the FOS can only represent individuals, not companies, and the maximum award is £150,000. If you're unhappy with the FOS ruling, you can take the matter to the small claims court, but it's worth considering whether a court is likely to rule differently than the ombudsman.

How to complain about your insurance provider

If you're dissatisfied with your insurance provider, there are a number of steps you can take to file a complaint. Here is a guide on how to complain about your insurance provider:

Contact your insurer

Before taking any action, check your policy document to ensure that what you want to complain about is covered by your policy. If it is, write to your insurer, detailing your complaint and what you would like them to do about it. Provide a timeframe for their reply and keep a copy of your letter. Send any correspondence by recorded delivery.

Make a formal complaint

If you are not satisfied with your insurer's reply, you can initiate a formal complaint using their official complaints process, which can be found in your policy documents or on their website. Follow the outlined steps to ensure your complaint is handled properly.

Contact the Policyholder and Market Assistance Department

If your insurer is a member of Lloyds and you are not satisfied with the outcome of your formal complaint, you can escalate the issue by filing a complaint with the Policyholder and Market Assistance Department.

Contact the Financial Ombudsman Service

If your issue still remains unresolved after contacting the Policyholder and Market Assistance Department, you can then take your complaint to the Financial Ombudsman Service. This service is free and available if you have already followed your insurer's complaints process. They will attempt to mediate the dispute, and if that fails, they will initiate a formal investigation. The final decision of this investigation is binding on your insurer, meaning they must adhere to the terms decided by the Ombudsman.

Take legal action

If you disagree with the decision made by the Ombudsman, you can choose to take your insurer to court. However, this option can be costly and stressful, so it should be considered a last resort. Additionally, a court will take into account any previous decisions made by the Ombudsman.

It is important to note that there are time limits for taking your complaint to the Ombudsman. You must do so within six months of receiving a final response from the trader, mentioning the six-month time frame, or within six years of the event you are complaining about. If you are outside these time limits, you may still refer your complaint, but it is at the discretion of the trader. If they object due to the time limits passing, the Ombudsman will not investigate.

What to do if your insurer dismisses your claim

If your home insurance claim has been dismissed, there are several steps you can take to try and resolve the issue. Firstly, it is important to understand why your claim was dismissed. There are several reasons why an insurance claim might be rejected, including incorrect or incomplete information, failure to take "reasonable care", omissions or inaccuracies in the application, technical "sticking points", or not following the proper claims process. Once you have identified the reason for the rejection, you can take the following steps:

Contact your insurer:

Check your policy documents to ensure that what you are claiming for is covered by your policy. If it is, write to your insurer, detailing your complaint and what you would like them to do about it. Give them a deadline to respond. Keep a copy of your letter and send it by recorded delivery.

Make a formal complaint:

If you are not satisfied with your insurer's response, you can make a formal complaint using their official complaints process, which can be found in your policy documents or on their website. Financial service providers are required to deal with complaints within eight weeks.

Contact the Financial Ombudsman:

If your insurer has not resolved your complaint within eight weeks or has rejected it, you can take your complaint to the Financial Ombudsman Service (FOS). The FOS is an independent, free service that investigates complaints against financial companies. They will attempt to resolve the dispute through mediation and, if that fails, will conduct a formal investigation. The decision made by the Ombudsman is binding on your insurer.

Seek financial compensation:

If your complaint is upheld by the FOS, you will be awarded financial compensation to restore you to your original financial position. The FOS can also require your insurance company to pay costs and/or compensation for distress or inconvenience caused.

Use the small claims court:

If you are still unhappy with the outcome, you can take the matter to the small claims court. However, consider whether a court is likely to rule differently than the ombudsman. There are monetary limits for using the small claims court process, which vary depending on your location.

What to do if your insurer refuses to pay you

If your insurer refuses to pay out, there are several steps you can take to resolve the issue. Firstly, it is important to stay calm and review the rejection letter or ask your insurance company why your claim was denied. It is possible that the problem lies with the filing process or an administrative error, which may be simple to fix. Review your policy carefully to ensure you understand what is and isn't covered. If necessary, seek the assistance of an attorney to help you understand your policy.

Next, contact your insurance company to ask how to start the appeal process. If your appeals are denied, you can contact your state regulator for guidance. Some states have an ombudsman who can help in these situations. You can also file a complaint about your insurer at your state's department of insurance.

In complex cases, you may wish to enlist the services of a lawyer who specialises in insurance complaints. It is important to keep detailed records of your interactions with your insurer and maintain all relevant documents.

If you are in the UK, you can make a formal complaint using your insurer's official complaints process. If you are still not satisfied with the outcome, you can take your complaint to the Financial Ombudsman Service, which will attempt to resolve the issue through mediation and, if necessary, a formal investigation. The final decision given by the Ombudsman is binding on your insurer. However, if you disagree with the decision, you can take your insurer to court.

The role of the Financial Ombudsman Service

The Financial Ombudsman Service is a free, UK-based service that resolves disputes between consumers and financial businesses. The service was set up by Parliament in 2001 to be a fair and impartial dispute resolution service. It is important to note that the Financial Ombudsman Service cannot deal with every complaint and there are time limits to making a complaint. Generally, the service can help with complaints about businesses that provide retail financial products and services in or from the UK.

The Financial Ombudsman Service can help with complaints about most kinds of financial products and services, including bank accounts, debt collection, payday loans, insurance, mortgages, pensions, annuities, and payment protection insurance (PPI). The service can also help with complaints about claims management companies (CMCs).

If a financial business and a customer cannot resolve a complaint themselves, the Financial Ombudsman Service will give an unbiased answer about what has happened. If the service decides that someone has been treated unfairly, it will use its legal powers to put things right. The final decision given by the Financial Ombudsman Service is binding on the financial business. This means that the business must stick to the terms of the decision made by the ombudsman. However, if the customer does not agree with the decision, they can take the financial business to court.

To make a complaint to the Financial Ombudsman Service, you must first contact the financial business you want to complain about and give them a chance to resolve the issue. The business has to give its final response to your complaint within eight weeks at most. If you are not happy with their response, or if the business does not reply in time, you can bring your complaint to the Financial Ombudsman Service.

When to take your complaint to court

There are several steps you can take if you have a complaint about your house insurance. First, you should contact your insurer, as there may be a good reason for their decision about your claim. Next, if you are still not satisfied, you can make a formal complaint using your insurer's official complaints process. If you are still unhappy with the outcome, you can take your complaint to an ombudsman service. In the UK, this would be the Financial Ombudsman Service.

The ombudsman will attempt to sort out your complaint using mediation. If this does not work, they will begin a formal investigation. The final decision given at the end of this investigation is binding on your insurer, but if you disagree with it, you can take your insurer to court.

Going to court can be stressful and costly, so it should be considered a last resort. A court will also take into account any decision that has already been made by an ombudsman. There are time limits for taking your complaint to court, and you should be aware that you will need to gather evidence and documentation to support your case.

Before taking your complaint to court, you should ensure that you have tried all other options, including contacting your agent for assistance, contacting the company, and sending the insurance company any information they have requested. You should also ask the company to explain their reason for not paying your claim. If you have already tried these steps, you may wish to proceed with legal action.

Frequently asked questions