Has your insurer rejected an insurance claim? That happens more often than you might think. Sometimes that’s justified, but often the rejection turns out to be incorrect or insufficiently substantiated. In that case, you can file an objection and compel the insurer to compensate your loss after all.
Why do insurers deny claims?
An insurer may only deny a claim if there is a legal or contractual basis for it. Common reasons include:
- The insurer claims that the loss is not covered.
- The insured allegedly breached their duty to notify (reported too late).
- The insurer suspects fraud or intentional deception.
- The policy contains exclusions (such as for theft without alarm class 3).
- The insurer believes the loss has not been sufficiently substantiated.
In practice, however, many denials turn out to be poorly substantiated. Often, a thorough investigation is lacking, or the insurer relies on assumptions instead of facts.
When is a denial unjustified?
A denial is unjustified if the insurer:
- has not investigated whether the policy does indeed provide coverage;
- has not fully established the facts;
- bases the rejection on an incorrect interpretation of the policy terms and conditions;
- has not adequately weighed the interests of the insured.
In addition, an insurer may not simply assert that there is fraud. For that, there must be sufficient evidence. If that is lacking, you can hold the insurer liable for the unjustified suspicion and for the damage you suffer as a result, for example in the case of an EVR registration.
What can you do in the case of a rejected insurance claim?
1. Request the rejection letter
The insurer must explain in writing why your claim was rejected. Always request this letter and check whether the reasoning aligns with your policy and the facts.
2. Submit an objection
Do you disagree with the rejection? Then submit a written objection to the insurer. Explain your position and refer to the relevant policy terms. Clearly indicate why the claim is indeed covered or why the suspicion is unfounded.
3. Engage a lawyer
If your objection is rejected or the insurer remains silent, you can be assisted by a lawyer. A specialized lawyer knows how to submit evidence, how the insurer must justify its position, and can pursue compensation on your behalf.
4. File a complaint with KiFiD
If you cannot reach a solution with the insurer, you can submit your case to the Financial Services Complaints Institute (KiFiD). The procedure is free and accessible. The decision can be binding, which means the insurer is obliged to compensate your loss after all.
5. Go to court
If even the KiFiD does not lead to a solution, you can submit the case to the civil court. Arslan Advocaten can litigate on your behalf to obtain compensation for your losses and, where necessary, also claim reimbursement of the costs.
Common mistakes by insurers
- Rejection without full investigation
- Too strict interpretation of the policy terms
- Incorrect application of an exclusion clause
- No balancing of interests when fraud is suspected
- No justification or late response
What can Arslan Advocaten do for you?
- We analyze your policy and assess the grounds for denial.
- We file an objection or start proceedings against the insurer.
- We support in complaints procedures at the KiFiD.
- We recover where possible the costs from the insurer, so that our help is free of charge for you.
Frequently asked questions about rejected insurance claims
How long do I have to appeal?
You can appeal immediately after receiving the rejection. Do not wait too long, as insurers often set deadlines of a few weeks.
What if the insurer accuses me of fraud?
Do not accept that allegation. Ask for evidence and legal grounds. It often turns out there are no hard facts. We help you clear your name and remove any registrations.
Can I hold the insurer liable?
Yes. If it turns out the rejection was unjustified, you can claim compensation, for example for repair costs or lost income.
Has your claim been unjustly rejected?
Contact Arslan Advocaten with no obligation.
We assess your file, lodge an objection, and make sure you receive what you are entitled to.
