Insurance Appeal Letter Template UK: Word-for-Word Scripts That Work

When your insurance claim is denied in the UK, the appeal letter you send to the insurer's complaints department can make the difference between getting paid and spending months waiting for a Financial Ombudsman Service investigation.

This guide gives you word-for-word template language, explains the structure that works, tells you what FCA references to include, and covers the common scenarios where appeal letters succeed. You can adapt these templates to your specific situation.

Why Your Appeal Letter Structure Matters

Insurance complaints handlers review hundreds of letters every month. A vague, emotional appeal ("I can't believe you're doing this to me after years of paying premiums") is easy to dismiss. A structured, evidence-based letter that references specific policy clauses, FCA Consumer Duty obligations, and clear factual grounds is much harder to ignore.

The goal of the internal appeal letter is threefold:

1. Create a clear, formal record that this is a dispute (starting the 8-week regulatory clock)
2. Force the insurer to address specific legal and factual arguments
3. Make it clear you know your rights and are prepared to go to the FOS if needed

The Essential Structure of a UK Insurance Appeal Letter

Every effective UK insurance appeal letter should contain these sections:

1. Opening: Formal complaint identification 2. Policy details: Reference numbers and parties 3. Statement of facts: What happened and when 4. Grounds for dispute: Why the denial is wrong 5. Evidence: What you're enclosing 6. Regulatory reference: FCA obligations 7. Remedy sought: Exactly what you want 8. Escalation warning: Your right to go to the FOS

Template 1: General Insurance Claim Denial Appeal

This template works for home, contents, travel, and other general insurance denials.

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[Your Name] [Your Address] [Date]

[Insurer Name] — Complaints Department [Insurer Address]

RE: FORMAL COMPLAINT — Disputed Claim Decision Policy Number: [XXXXX] Claim Reference: [XXXXX]

Dear Sir/Madam,

I write to lodge a formal complaint regarding the decision on my claim referenced above, which I received by letter dated [date of denial letter]. I dispute this decision in full and request a complete review.

Background and Statement of Facts

On [date of event], [brief factual description of what happened — e.g., "my property sustained damage from a burst pipe"]. I notified [Insurer Name] on [date] and submitted a claim on [date], supported by [list evidence submitted].

By letter dated [date], I was informed that my claim was denied on the grounds of [specific reason stated in denial letter, e.g., "wear and tear exclusion under Clause 7.3"].

Grounds for Dispute

I dispute this decision for the following reasons:

1. The exclusion cited does not apply to my circumstances. Clause 7.3 of my policy document excludes damage resulting from "gradual deterioration or wear and tear." The damage I sustained was sudden and accidental, caused by [specific cause]. This is clearly distinguishable from gradual deterioration and does not fall within the clause's plain meaning.

2. The insurer has mischaracterised the facts. The claim assessor's report states [quote from report]. However, this is inconsistent with [counter-evidence, e.g., "the independent plumber's report I am enclosing, which confirms the pipe failed suddenly due to a manufacturing defect"].

3. The FCA Consumer Duty requires fair outcomes. Under the FCA's Consumer Duty (PS22/9), my insurer is required to act to deliver good outcomes for retail customers. A denial that misapplies a policy exclusion to a clearly covered event is contrary to this obligation.

Enclosed Evidence

I enclose the following documents in support of my complaint:

• [List all documents, e.g., "1. Independent plumber's report dated [date]"]
• [2. Photographs of the damage taken on [date]]
• [3. Copy of the original claim submission]

Remedy Sought

I request that [Insurer Name] reverse the denial decision and pay my claim in full, including [specific amount if known]. I also request reimbursement of any costs directly caused by the delay in payment, including [list if applicable].

Right to Escalate

I am aware that if you do not issue a final response within 8 weeks, or if your final response does not resolve this complaint, I am entitled to refer this matter to the Financial Ombudsman Service (FOS) free of charge. I reserve that right fully.

Please acknowledge receipt of this letter and confirm the name and contact details of the complaint handler assigned to my case.

Yours faithfully,

[Your Name] [Contact details]

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Template 2: Health or Protection Insurance Denial (Non-Disclosure Allegation)

Use this template when the insurer is alleging you failed to disclose a medical condition.

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RE: FORMAL COMPLAINT — Disputed Denial on Non-Disclosure Grounds Policy Number: [XXXXX]

Dear Sir/Madam,

I write as a formal complaint regarding [Insurer Name]'s decision dated [date] to deny my claim on grounds of alleged non-disclosure of [the condition stated in the denial letter].

Why the Non-Disclosure Allegation Is Incorrect

[Insurer Name] asserts that I failed to disclose [specific condition] when applying for this policy on [application date]. I dispute this on the following grounds:

1. The condition did not exist at application. At the time I completed the application, I had not been diagnosed with [condition], nor had I experienced symptoms that a reasonable person would have associated with a condition requiring disclosure. My GP records, enclosed herewith, confirm that [condition] was first diagnosed on [date after policy start].

OR

1. The condition was not material to the insurer's underwriting. Even if [condition] had been disclosed, [Insurer Name] has not demonstrated that the disclosure would have led to a different underwriting decision. Under the Consumer Insurance (Disclosure and Representations) Act 2012 (CIDRA), the insurer must show that the non-disclosure was material. If the same premium and terms would have been offered, there is no qualifying misrepresentation.

2. Any non-disclosure was innocent, not deliberate or reckless. Under CIDRA, the remedy available to an insurer depends on whether non-disclosure was deliberate/reckless, careless, or innocent. Innocent non-disclosure entitles the insurer only to a proportional remedy — not outright voidance of the claim. I was not asked specifically about [condition] on the application form, and I answered all questions honestly to the best of my knowledge.

Supporting Evidence Enclosed

• Copy of original application form (showing questions asked)
• GP records showing [condition] was not diagnosed until [date]
• Specialist letter from [Dr. Name] confirming diagnosis timeline
• [Any other relevant medical records]

Remedy Sought

I request that [Insurer Name] reconsider the denial, pay my claim in full, and confirm the basis on which it determined the non-disclosure was material and the specific underwriting decision that would have changed.

Yours faithfully, [Your Name]

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Template 3: Travel Insurance Denial (Pre-Existing Condition)

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RE: FORMAL COMPLAINT — Travel Insurance Claim Denial, Pre-Existing Condition Policy Number: [XXXXX] Claim Reference: [XXXXX]

Dear Sir/Madam,

I write to formally dispute [Insurer Name]'s decision to deny my travel insurance claim on the grounds that my medical treatment overseas related to a pre-existing condition.

My Dispute

My policy was purchased on [date] for travel from [date] to [date]. I underwent [treatment] at [hospital] on [date] while in [country].

[Insurer Name] has denied my claim by asserting that [specific condition] constitutes a pre-existing condition under Clause [X] of my policy.

I dispute this for the following reasons:

1. The condition was declared / was not a pre-existing condition at the time of purchase. [State facts: e.g., "I declared this condition via the online medical screening tool on [date] and was issued a policy that covered it" OR "At the date of purchase, I had not been diagnosed with this condition, nor had I been treated for it within the 12-month lookback period specified in Clause [X]"].

2. The treatment I received was for an acute emergency, not a chronic condition. My treating physician's letter, enclosed herewith, confirms that the episode I experienced was an acute exacerbation requiring emergency intervention. This is distinguishable from routine management of a chronic condition.

3. The policy wording is ambiguous and should be construed in my favour. Clause [X] does not clearly define what constitutes "active treatment" or "medical advice sought" within the lookback period. Under the doctrine of contra proferentem, ambiguous terms in an insurance contract are construed against the party that drafted them.

Yours faithfully, [Your Name]

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What to Include with Every Appeal Letter

Regardless of the template you use, always enclose:

• A clear cover sheet listing all enclosed documents by number
• Your denial letter (copy)
• Your full policy schedule and policy wording
• All supporting evidence numbered and referenced in the letter
• Any previous correspondence with the insurer about this claim

Send by recorded delivery or email with read receipt. Keep copies of everything.

Key FCA References to Use in Your Letters

Including regulatory references shows the insurer you know the rules:

• Consumer Duty (PS22/9 / PRIN 12): Requires insurers to deliver good outcomes for retail customers
• ICOBS 8.1.1: Insurers must handle claims promptly and fairly
• CIDRA 2012: Governs non-disclosure in consumer insurance contracts
• FOS jurisdiction: Remind them you can refer if not resolved within 8 weeks

Common Mistakes in Appeal Letters

Too emotional, not factual: State facts and reference clauses, not feelings.

Not referencing the specific exclusion clause: Name the clause number the insurer cited.

No evidence attached: Letters without supporting documentation are weak.

Forgetting to state the remedy: Be explicit — "I want my claim paid in full" or "I want the decision reconsidered."

Not clearly labelling it a formal complaint: Use the words "formal complaint" to start the 8-week regulatory clock.

Let ClaimBack Write Your Letter Automatically

Writing these letters from scratch is time-consuming, and getting the regulatory references right for your specific claim type and denial reason requires careful research.

ClaimBack (claimback.app) generates tailored UK insurance appeal letters in minutes. Answer a few questions about your policy, what happened, and why the insurer denied your claim, and the tool produces a professional, regulation-referenced letter ready to send. It's free to use and takes about five minutes.

Summary

• Structure your letter with clear sections: facts, grounds, evidence, remedy, escalation warning
• Reference specific policy clauses the insurer cited — and argue against them specifically
• Include CIDRA 2012 and FCA Consumer Duty references where relevant
• Label it clearly as a formal complaint
• State exactly what remedy you want
• Enclose all supporting evidence in a numbered bundle
• Send by recorded delivery or tracked email