Denied by Bupa, AXA Health, Aviva, VitalityHealth, or Cigna UK? With 8.4 million UK residents holding private medical insurance, claim denials are common — but your rights are strong. FCA Consumer Duty and the Financial Ombudsman Service (FOS) give you powerful, free appeal rights. ClaimBack writes your professional letter in 3 minutes.
Takes 3 minutes · No login required · FOS-ready letters
UK consumers have some of the strongest insurance protections in the world. The FCA regulates all insurers, and the Financial Ombudsman Service provides free, binding dispute resolution. Here are the four pillars of your rights.
Under the FCA's Dispute Resolution (DISP) rules, your insurer must acknowledge your complaint promptly and issue a Final Response Letter within 8 weeks. If they fail to respond in time, or you disagree with their decision, you can escalate directly to FOS. The insurer must clearly explain your right to go to FOS in every Final Response. Failure to follow DISP is itself a regulatory breach you can cite in your appeal.
FOS is a free, independent complaint service — you pay nothing. FOS decisions are binding on insurers and can award compensation up to £430,000. Across insurance complaints, FOS upholds 19–30% in favour of consumers. Cases with clear FCA rule citations and structured documentation perform significantly better. ClaimBack's letters are built to hit exactly these standards.
The FCA's Consumer Duty (effective July 2023) requires all PMI insurers to deliver "good outcomes" for customers, provide products of fair value, and communicate clearly. Insurers cannot rely on unfair contract terms under the Consumer Rights Act 2015. If your denial letter is vague, uses exclusions buried in fine print, or fails the fair-value test, you likely have grounds for a successful complaint.
Even if you paid out of pocket rather than through PMI, you still have complaint rights. You can report concerns about private hospitals and clinics to the Care Quality Commission (CQC), and check hospital performance data through the Private Healthcare Information Network (PHIN). If a provider overcharged or delivered substandard care, PHIN transparency data strengthens your case.
Three steps. No jargon. No legal degree required.
The UK private medical insurance (PMI) market covers approximately 8.4 million residents, with over £4 billion in claims paid annually. Bupa dominates with an estimated 40–50% market share, followed by AXA Health, Aviva, VitalityHealth, and Cigna UK. Despite this scale, many policyholders never challenge a denied claim — even though the regulatory framework strongly favours consumers who do.
The Financial Conduct Authority (FCA) regulates all UK insurers under rules including ICOBS (Insurance Conduct of Business Sourcebook) and DISP (Dispute Resolution). Since July 2023, the FCA Consumer Duty has raised the bar further, requiring insurers to demonstrate that their products deliver fair value and that claim decisions are clearly communicated. Insurers who issue vague or boilerplate denial letters may be in breach of these obligations.
If your insurer denies your claim, you have the right to escalate to the Financial Ombudsman Service (FOS) — a free service that can make binding decisions up to £430,000 in compensation. FOS data shows that 19–30% of insurance complaints are upheld in the consumer's favour, and cases with well-structured arguments citing specific FCA rules perform significantly above this average. ClaimBack generates exactly this kind of letter: professional, regulation-specific, and FOS-ready.
Join thousands of UK policyholders who refused to accept an unfair denial. Generate a professional, FCA-compliant appeal letter in minutes — completely free to start.
Fight My Denial Now →Free to start · No login · FOS-ready in 3 minutes
ClaimBack provides AI-assisted document drafting. We are not a law firm, not regulated by the FCA or SRA, and do not provide legal or financial advice. Our letters are designed to help you articulate your complaint using publicly available FCA and FOS guidance.