Getting a claim declined can feel like a punch to the gut, especially when you were counting on the pay-out to get you back on your feet. It’s not a great situation to be in, which is why we do our best to make sure that everyone who joins our kingdom understands their cover, knows what’s included and what isn’t, is familiar with the rules, and has access to our easy-to-read policy docs. Our job is to cover your valuables against a lot of risks, so believe us when we say, we’re here for you.
But what if your claim is rejected by your insurance? To help you figure out your next steps, here’s a straightforward guide to help you navigate the murky waters of a declined claim and get back on track.
So… Why was your claim declined
First things first, you need to know the ‘why’ behind your claim denial. If there are any other steps to be taken, you’ll find out when you understand why your claim got rejected.
Here are some common culprits:
- Insufficient cover: Sometimes, you thought your policy covered this, that, and the other, but actually, it was only this and that. Not the other. Most of the time, ‘the other’ is something you need to specify, add on, or get a different policy for.
- You were late: Insurance policies often require claims to be filed within a specific timeframe, and if you miss that window, your claim might be denied.
- Missing docs: Claims require evidence that we can process to come to a decision, and if you don’t provide the necessary paperwork, there’s no choice but to reject the claim.
- The exclusions: All insurance policies have specific exclusions, which are things that won’t be covered, like if you were in an accident and were drunk when the accident happened. Most insurers reject car insurance claims if you were drunk at the time of the incident.
Our advice? Always read the fine print, and always double-check the exclusions. Familiarising yourself with these details can save you from future headaches.
What to do when the heartache settles
We pride ourselves on acting fairly, following the terms and conditions of our policies to the letter, being kind, and never rushing to a decision. Every claim is dealt with on a case-by-case basis, and is investigated thoroughly. Seriously, we don’t take this lightly.
But not everyone is insured with us. So, if your insurer has broken your heart and your claim has been rejected, what do you do? Well, to handle things fairly and in good order from your side, here’s what to do next…
Start by reading the rejection letter. This is your roadmap. It should explain why your claim was denied and outline your options for appeal. If you aren’t satisfied with the explanation, then first try reaching out to your insurer. Sometimes, a quick call can clear up misunderstandings, so call and ask for clarification on the denial and see if there’s a way to resolve it. Of course, if this doesn’t do the trick, then there’s the appeal. Every insurer is different, so it’s best to follow the instructions in the denial letter, which should clearly lay out who to contact next and how long you have to make your appeal.
If, at the end of the day, your appeal is denied and you’re still not satisfied, you may want to reach out to the OSTI, which is the Ombudsman for Short-Term Insurance. They can investigate and make a final ruling.
Let’s talk about preventing future denials
This isn’t the insurance experience we want for anyone, so to help you avoid the frustration of a denied claim in the future, keep these tips in mind:
Know your policy. Regularly review your insurance policy to understand your cover and exclusions.
Document it all. Keep detailed records of all communications with your insurer and document incidents that may lead to a claim.
Stay informed. Keep up with changes in your policy and if something doesn’t make sense, call us and we’ll happily take you through your options.
The king’s got your back
We don’t just offer insurance. We provide peace of mind, and we do it by providing comprehensive cover and affordable premiums so that your valuables are well-protected against life’s little surprises.
For more details on our cover and to see how we can tailor a policy to your needs, click here or WhatsApp us on 0860 50 50 50. You can even our click here to look at our policy docs.
