Has your insurer rejected a claim for damage? This happens more often than you think. Sometimes this happens rightly, but often the rejection is incorrectly or incompletely motivated. In that case you can object and force the insurer to compensate the damage after all.
Why do insurers reject damage?
An insurer may only reject a claim if there is a legal or contractual basis for it. Common reasons are:
- The insurer claims that the damage is not covered by the coverage.
- The policyholder is said to have breached his reporting obligation (reported too late).
- The insurer suspects fraud or deliberate deception.
- The policy contains exclusions (such as theft without alarm class 3).
- The insurer believes that the damage has not been sufficiently proven.
Yet in practice it turns out that many rejections are not well motivated. Often there is a lack of thorough investigation or the insurer relies on assumptions instead of facts.
When is a rejection unfair?
A rejection is unfair if the insurer:
- has not investigated whether the policy does provide coverage;
- has not fully established the facts;
- bases the rejection on incorrect interpretation of the policy conditions;
- has not sufficiently taken into account the interests of the insured.
In addition, an insurer cannot simply state that there is fraud. This requires sufficient evidence. If this is lacking, you can address the insurer for the unjust suspicion and the damage you suffer as a result, for example in case of EVR registration.
What can you do when a damage claim is rejected?
1. Request the rejection letter
The insurer must explain in writing why your damage has been rejected. Always request this letter and check whether the motivation matches your policy and the facts.
2. File a complaint
Do you disagree with the rejection? Then file a written objection with the insurer. Explain your position and refer to the relevant policy conditions. Clearly indicate why the damage is covered or why the suspicion is unfounded.
3. Engage a lawyer
Is your objection rejected or does the insurer remain silent? In that case you can be assisted by a lawyer. A specialized lawyer knows how to provide evidence, how the insurer must motivate and can claim the damage on your behalf.
4. File a complaint with the KiFiD
If you do not reach a solution with the insurer, you can present your case to the Complaints Institute for Financial Services (KiFiD). The procedure is free and accessible. The ruling can be binding, forcing the insurer to compensate your damage after all.
5. Go to court
If the KiFiD also does not lead to a solution, you can bring the case before the civil court. Arslan Advocaten can litigate on your behalf to get your damage compensated after all and if necessary also claim compensation for the costs.
Common mistakes by insurers
- Rejection without full investigation
- Too strict interpretation of the policy conditions
- Wrong application of a ground for exclusion
- No consideration of interests in case of suspicion of fraud
- No motivation or late reaction
What can Arslan Advocaten do for you?
- We analyze your policy and assess the grounds for rejection.
- We object or initiate a procedure against the insurer.
- We assist with complaints procedures at the KiFiD.
- We claim where possible the costs from the insurer, so that our help is free for you.
Frequently Asked Questions About Rejected Damage Claims
How long do I have to object?
You can object immediately upon receipt of the rejection. Don’t wait too long, as insurers often use periods of a few weeks.
What if the insurer accuses me of fraud?
Don’t put up with that accusation. Ask for proof and legal underpinning. Often it turns out that there are no hard facts. We help you clear your name and if necessary remove any registrations.
Can I hold the insurer liable?
Yes. If it turns out that the rejection was unjustified, you can claim damages, for example for the cost of repair or loss of income.
Has your damage been unfairly rejected?
Feel free to contact Arslan Advocaten.
We assess your file, object and ensure that you get what you are entitled to.
