Insurance law solicitor — resolving disputes with your insurer
You take out insurance to cover a risk. But what if your insurer refuses to pay, rejects your claim, or accuses you of fraud? Disputes with insurers are more common than people expect, and the consequences are serious: no cover, and often costs on top. Our insurance law specialists act for private clients and businesses in disputes with their insurer, in English, Turkish, Polish and Dutch.
What kinds of disputes do we handle?
1. A rejected claim
- The insurer argues that the damage falls outside the cover.
- Disagreement about the policy conditions or the exclusions.
- Delay in payment, or refusal to pay at all.
2. Allegations of fraud and registration in the EVR
- An unfounded accusation of fraud.
- Registration in the Extern Verwijzingsregister (EVR), which can make you effectively uninsurable.
- Proceedings to have an EVR registration removed.
3. Cancellation or termination of the policy
- The insurer ends the policy for an alleged breach of the conditions.
- Disagreement about automatic renewal or the notice period.
4. Health, disability and life insurance
- Refusal to pay out on incapacity for work.
- Disputes about the health declaration you gave when taking out the policy.
- Disputes about term life and life insurance.
5. Liability and legal expenses insurance
- Rejection of liability claims.
- A legal expenses insurer that refuses to provide assistance.
- Disputes about the free choice of lawyer.
Two deadlines that decide your case
Report the loss without delay, and do not let the claim become time-barred. Under Article 7:941 of the Dutch Civil Code you must notify the insurer as soon as you reasonably can; late notification only costs you your right to payment if the insurer is actually prejudiced by it, or in cases of intent to mislead. Separately, Article 7:942 sets a limitation period of three years from the day after you became aware that payment was due; once the insurer has rejected the claim in writing, a new period starts running. Missing that deadline ends the case regardless of its merits.
What you told the insurer when you took out the policy
Insurers often fall back on the duty of disclosure. Article 7:928 of the Dutch Civil Code requires you to tell the insurer, before the contract is concluded, everything you know or ought to know that is relevant to the risk. If something was left out, the consequences are set out in Article 7:929 and Article 7:930. Those consequences are graduated: an insurer cannot simply refuse everything. Where the insurer would still have accepted the risk on different terms, payment is reduced rather than cancelled. That distinction is often where a rejected claim can be turned around.
Intent, recklessness and the fraud allegation
An insurer does not have to cover damage you caused intentionally or with reckless disregard (Article 7:952 of the Dutch Civil Code). But the burden of proving intent lies with the insurer, and in practice that burden is a heavy one. A suspicion, an inconsistency in a statement, or the findings of an investigation bureau are not the same thing as proof.
The consequences of a fraud finding reach beyond the single claim. A registration in the EVR is shared between insurers through Stichting CIS, and it can block you from taking out insurance, and sometimes from obtaining credit, for years. A registration must be proportionate and properly substantiated; where it is not, it can be challenged and removed.
Free choice of your own lawyer
If you have legal expenses insurance and a court or administrative procedure is started, you may choose your own lawyer — the insurer pays. This right follows from Article 4:67 of the Dutch Financial Supervision Act (Wet op het financieel toezicht) and from the case law of the Court of Justice of the European Union, which reads the concept of a “procedure” broadly. Insurers do not always mention this right of their own accord. If you are in a dispute and your insurer has assigned you an in-house lawyer, it is worth asking about it.
How a case against an insurer runs
- Policy and claim analysis — we go through your policy conditions and the stated ground for the rejection.
- Negotiation with the insurer — a settlement is often reachable once the legal position is set out properly.
- Kifid or the civil court — where necessary we litigate before the Financial Services Complaints Board (Kifid) or the civil court. Which route is better depends on the amount at stake, the evidence and the time available; we will tell you which we think fits your case.
- Payment or reinstatement — the aim is that you receive what you are entitled to, or that a registration against you is removed.
What to do if your insurer rejects your claim
- Read the policy conditions and the rejection letter carefully; the stated ground determines the defence.
- Collect all correspondence, photographs, reports and evidence before anything is lost.
- Do not sign a settlement or a statement under time pressure.
- Watch the deadlines: the three-year limitation period, and any period stated in the rejection letter.
Frequently asked questions
Can my insurer simply cancel my policy?
No. Cancellation is only possible on the grounds set out in the policy conditions and in the law, and it must be properly reasoned. An unjustified cancellation can be challenged.
What is an EVR registration?
A registration in the Extern Verwijzingsregister, the external warning register used by financial institutions in cases of suspected fraud. It is shared through Stichting CIS and makes taking out new insurance very difficult. Registrations that are disproportionate or insufficiently substantiated can be removed.
Kifid or the court?
Kifid is the more accessible route for consumers; the court is sometimes the better one, for example where evidence has to be taken or the amount is substantial. We advise on the choice before you commit to either.
Am I entitled to choose my own lawyer under my legal expenses policy?
Yes, once a judicial or administrative procedure is started. See the section above.
What will it cost?
That depends on the case. We set out the basis for our fees before we start, and we will tell you when we think the costs are not proportionate to what is at stake.
How are unclear policy conditions interpreted?
Policy conditions are interpreted objectively, and where a condition drafted unilaterally by the insurer is open to more than one reading, it is in principle read against the insurer. That is the contra proferentem rule: whoever writes the text carries the risk of its ambiguity. It applies only where the wording genuinely allows different readings — not to conditions that are unambiguous.
For consumers the rule is anchored in statute. Article 6:238(2) of the Dutch Civil Code requires clauses in general terms to be drafted “clearly and comprehensibly”, and provides that in case of doubt the reading most favourable to the other party prevails. In addition, such a clause is voidable under Article 6:233 DCC if it is unreasonably onerous, or if you were not given a reasonable opportunity to take note of it.
In that objective interpretation the courts look at the wording itself, read in the light of the policy conditions as a whole and any explanatory notes, the meaning of the term in ordinary usage, the purpose of the provision and the nature of the insurance. Two practical consequences: lay the exclusion word for word next to your actual situation — many rejections rest on a reading wider than the text allows — and keep every version of the conditions you were sent, including the explanatory notes.
Exclusions and the policy excess: what can the insurer rely on?
An insurer is free to define the limits within which it provides cover, but a party invoking an exclusion must also make it good. The distinction between the primary description of cover and an exclusion decides how much room there is to argue.
The primary description says what is insured; reliance on it cannot be defeated merely by arguing that this would be unacceptable by standards of reasonableness and fairness. An exclusion, by contrast, takes something away from cover that in principle exists. There is more room there: its interpretation is open to argument, and the insurer bears the burden of pleading and proving the facts on which it relies.
| Exclusion | What the argument is usually about |
|---|---|
| Intent and recklessness | whether the conduct meets the policy definition, and whether the insurer proves it |
| Alcohol or drugs | whether use is actually established and whether the clause is sufficiently precise |
| Inadequate security or prevention | what exactly was prescribed, and whether that was made known to you |
| Deferred maintenance or wear | whether the damage was caused by that, or by an insured event |
| Pre-existing defects or earlier complaints | the causal link with the damage reported |
| Breach of policy obligations | whether there is a valid forfeiture clause and whether its requirements are met |
The policy excess is something different from an exclusion: it is the amount that remains contractually for your account.
Can I appoint my own expert? The counter-expertise
Yes — under almost all indemnity policies you may appoint your own expert to assess the loss, and those costs are usually borne by the insurer, provided the policy says so and you follow the procedure it prescribes. The expert who visits after a fire or a burglary is the insurer’s expert. That does not make them careless, but they are not your expert.
Most policies set out a fixed structure: the extent of the loss is established either by mutual agreement, or by a single expert appointed jointly, or by two experts of whom you appoint one and the insurer the other. In that third variant a deed of appointment records that the two valuations serve as proof of the extent of the loss, and that the experts appoint a third expert in advance who, in case of disagreement, decides bindingly within the limits of the two valuations.
- Invoke it in time. The right to a counter-expertise must be exercised before the assessment of the loss is finalised.
- Watch the status of the outcome. A valuation by two or three experts is usually binding as to the amount — an advantage if it goes your way, a risk if you sign without knowing what you are signing.
- Expertise is about the amount, not about cover. Whether there is cover at all is a legal question that sits outside it; do not let it disappear into the expert’s report.
Disability insurance for the self-employed: where it goes wrong
In a Dutch disability policy (AOV) almost every dispute turns on one question: unfit for what — for your own occupation as you actually practised it, or for work in a broader sense? The answer is not in the law but in your own policy conditions. An AOV is private insurance: there is no UWV framework that determines the outcome.
| Pressure point | What happens |
|---|---|
| The insured occupation on the policy schedule | if it says “director” while you in fact worked on the tools, you are assessed against that — and vice versa |
| “Medically objectifiable” | with complaints that show no demonstrable abnormality, this is the heart of the dispute |
| First-year and post-first-year criteria | many policies apply a different test after 52 weeks; that is where payments stop |
| Unilateral reassessment | the insurer has you reassessed and reduces or ends the benefit |
What carries an AOV file: putting the policy definition literally next to your situation (not “am I ill” but “do I meet the description this policy gives”), a precise description of your actual duties — which tasks, how many hours, at what physical load — and obtaining the medical and occupational reports so they can be challenged on their substance.
The duty of care of your insurance intermediary
An insurance intermediary must show the care that may be expected of a reasonably competent and reasonably acting professional; if it falls short, it can be liable for the loss you suffer — even where nothing can be held against the insurer itself. This is a second track that is regularly overlooked: besides the question whether the insurer must pay, there is the question whether the adviser put you in the position you are now in. The standard follows from the duty of care of a good contractor under Article 7:401 DCC.
- When taking out the policy: did the intermediary point out the scope of the questions and the consequences of answering them incompletely?
- In the advice: does the cover chosen fit what you told them about your situation, and did they check for gaps in cover?
- When a loss occurs: did they notify the insurer in time and inform you about the deadlines?
That duty is not unlimited — an adviser need not, without specific instructions, map out how risk is allocated in your contracts with customers. Practical tip: on a rejection, ask your intermediary for the complete file. It usually shows exactly what was and was not disclosed, and to whom.
How do I complain about my insurer?
First the insurer’s own internal complaints procedure, then the Financial Services Complaints Board (Kifid), and alongside that the civil courts. Kifid is generally the more accessible route for consumers and small businesses; the court is sometimes better, for example where evidence has to be taken or the amount at stake is substantial. Note that choosing one route can close the other, so decide before you file rather than afterwards.
Talk to us about your situation
The first conversation is free of charge and confidential: we will tell you where you stand, which deadlines are running, and whether we think a case is worth bringing. Call +31 70 450 0300 or request a review.
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Assessment of liability issues
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Holding third parties liable
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Claims for damages
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Defense against liability claims directed at you
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Complaint procedures against your insurer
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Inclusions in internal and external registers (including CIS) due to fraud
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Disputes over the interpretation of policy conditions
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This page is published under the responsibility of the insurance law team at Arslan Advocaten. Last updated: 13 September 2026. This page is general information and does not replace individual legal advice; what applies to you depends on your own policy conditions.