Has your building insurance claim been rejected

Here’s How to Complain

Date:  23 March 2016

Many homeowners invest in buildings insurance to cover the costs of structural damage to their property.  It’s there to provide much needed financial assistance for costly repairs to roofs, walls, ceilings, floors, doors and windows, as well as outdoor structures such as garages and fences should the following types of damage occur:

  • fire
  • explosions
  • bad weather, including lightening, storms and flooding
  • earthquakes
  • subsidence
  • impact by vehicles, falling trees, lampposts, aerials or satellite dishes
  • freezing or bursting of any part of the plumbing system
  • theft or attempted theft
  • malicious damage or vandalism

This type of cover is essential to providing homeowners with peace of mind that they’ll receive sufficient financial assistance to restore and repair their property.  However, as a recent study from the Association of British Insurers (ABI) showed, more than one in five home insurance claims is unsuccessful.  Leaving many without the finances available to complete necessary repairs to restore their home to a safe and sound condition.

Common reasons for building insurance claims being turned down

  • damage deemed to be “wear and tear” and therefore excluded under the policy
  • the claim value being below the policy excess
  • insufficient cover being bought at the start of the policy to cover such things as accidental damage
  • policy complexity as to what’s included and excluded
  • disputes between interpretation of terms and clauses contained within a policy
  • the homeowner not having maintained the condition of their property in-line with the conditions of their policy
  • homes being underinsured – meaning that your home was not insured to its full value
  • an insufficient level of insurance being in place if your home is at greater risk of regular flooding or subsidence.

For anyone who has suffered damage and is in need of help, this is an extremely frustrating situation to be in.  Particularly if you believe the reason for the claim being rejected is unfair.

If you’re in a situation where you’re unhappy with how your claim has been handled, the good news is that mechanisms are in place for you to dispute the service you received or the decision made. 

The Financial Conduct Authority (FCA)

The FCA regulate the financial services industry in the UK. Their aim is to protect consumers, ensure the industry remains stable and promote healthy competition between financial services providers.

Insurance companies regulated by the Financial Conduct Authority (FCA) must have a procedure in place for resolving disputes with their customers and responding to them within set deadlines.

Where the policy holder has gone through the dispute process and remains unsatisfied with the  insurer’s decision, they can take their complaint to the Financial Ombudsmen Service (FOS)

Here the complaint will be looked at objectively, taking into account both sides of the story to find an outcome that is satisfactory to the circumstances of the individual case.  Initially the Ombudsmen will try and find a solution via mediation.  But where disputes can’t be resolved in this manner they will then follow a process of formal investigation.

The Complaint Process

1.  Contact your insurer directly

The first course of action is to try and resolve the dispute with your insurer, to give them the opportunity to investigate your concerns and put things right.

Use your insurer’s formal complaints procedure and contact them as soon as possible in writing giving details of your complaint and how you would like it resolved.

Financial firms regulated by the FCA are obliged to respond in writing to complaints they receive within eight weeks.  Their response should include details of whether the complaint has been successful or why more time is needed to investigate it further.

They must also initially respond in writing to let you know that your complaint has been received.

Before contacting the FOS you should ensure that you have received a final response from your insurer, or that it has been eight weeks since you first complained.

2.  Contact the Financial Ombudsmen Service

Where you have received a response from your insurer and are unhappy with their decision, they reject your complaint or you have not heard from them within the eight weeks period you can contact the FOS for help.

This is a free consumer service set up by parliament to help sort out disputes that consumers and financial businesses are unable to resolve themselves.

Once you have contacted the FOS with details of your case, they will contact your insurance company to ask them for details of what they think happened in order to decide if your complaint should be upheld.

For the FOS to look into your complaint, it’s important that you contact them within six months of receiving the final response from your insurer.

After investigation the FOS will deliver their final decision which is binding on your insurer.

3.  Take the matter to court only as a last resort

If you remain unhappy with the decision of the FOS your final resort is to seek legal action.  However, this is only recommended after all other avenues have been exhausted, as the amount of compensation awarded by a court may be reduced if other ways of resolving the problem haven’t been sought first.

Prior to taking legal action, you should first consider whether you have sufficient evidence to back up your claim.  You will also need to prove that your claim is covered by your insurance policy.  There is also the possibility that you may be required to provide expert evidence.

Contact Tangible Building for help

Whilst the above is in place for those wishing to make a complaint, it can be a stressful and time consuming process.

There is an alternative approach which removes the hassle of making a complaint yourself. Tangible Building are builders who specialise in building insurance claims work. We have seen many instances where claims have been wrongly turned down, and are highly experienced in acting on behalf of our clients in challenging rejected claims.

If you believe your claim has been unfairly rejected your first point of call is to speak to one of our advisers. We then arrange for a member of the Tangible team to visit your home to carry out a professional assessment of damage. We then deal with your insurers and their representatives on your behalf to bring about a swift and stress free claim and repair process.

For help with your building insurance claim call Tangible Building advice team on 0800 328 4188

More information

Check that your insurer is a member of the FCA using the FCA Register

The Financial Ombudsman Consumer Complaints Process

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Suite 220, SK House, Vansittart Estate, Windsor, Berkshire, SL4 1SE.

Jane Smith

Regional Director at Thames Valley Office

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