Insurance Claim Denied UK: Your Step-by-Step Guide to Fighting Back (2026)

Having your insurance claim denied is one of the most frustrating experiences a policyholder can face. You paid your premiums, filed your claim in good faith, and then received a letter telling you the insurer won't pay. In the UK, however, you have robust legal protections — and a clear pathway to challenge that decision.

This guide walks you through exactly what to do, what your rights are under FCA regulations, and how to escalate your complaint all the way to the Financial Ombudsman Service (FOS) if needed.

Why Do Insurers Deny Claims?

Before diving into the appeal process, it helps to understand the most common denial reasons UK insurers use:

• Non-disclosure: The insurer claims you failed to disclose a material fact when applying for the policy.
• Policy exclusions: The event you're claiming for falls outside the scope of coverage.
• Waiting periods: Your claim falls within a period during which coverage hasn't yet activated.
• Pre-existing conditions: Your health condition predates the policy start date.
• Insufficient evidence: The insurer says you haven't provided adequate proof of the loss or event.
• Wear and tear / gradual deterioration: Common for home and contents policies.

Understanding the specific reason listed in your denial letter is the foundation of your entire appeal strategy. Read the denial letter carefully — insurers are required under FCA rules to give you a clear explanation.

Your Rights Under FCA Regulations

The Financial Conduct Authority (FCA) regulates all UK insurers and sets strict standards for how they must handle complaints. Key protections include:

The Consumer Duty (2023): Requires insurers to deliver good outcomes for customers. This includes paying claims that should be paid, promptly and fairly.

ICOBS (Insurance: Conduct of Business Sourcebook): Sets out rules on how policies must be explained and how claims must be handled. Insurers must assess claims fairly and promptly.

The right to a timely final response: Once you make a formal complaint, your insurer has 8 weeks to issue a "final response letter" before you can escalate to the FOS.

Right to escalate for free: Any consumer can take their complaint to the FOS at no cost. There is no filing fee.

Step-by-Step: How to Appeal a Denied Insurance Claim in the UK

Step 1: Review the Denial Letter in Full

Read every word of your denial letter. Note the specific clause or exclusion the insurer is citing. Request a copy of your full policy documents if you don't have them. You are legally entitled to these.

Cross-reference the denial reason with the exact policy wording. Insurers sometimes cite exclusions that don't actually apply to your circumstances, or interpret policy language in ways that favour themselves over the policyholder.

Step 2: Gather Your Evidence

Build a file that addresses each specific reason given for the denial. This might include:

• Medical records or doctor's letters (for health and life claims)
• Photos, receipts, or repair estimates (for home, travel, or contents claims)
• Police reports or crime reference numbers (for theft claims)
• Correspondence showing you disclosed all relevant information at application

The stronger your evidence bundle, the harder it is for the insurer to maintain their position.

Step 3: Write a Formal Internal Complaint

Send a formal written complaint to your insurer's complaints department. Do not just call — written complaints create a paper trail and start the clock on their 8-week deadline.

Your complaint letter should:

• Reference the policy number and claim reference
• State clearly that you are disputing the denial
• Set out why you believe the denial is incorrect, referencing specific policy clauses
• List all supporting documents you are enclosing
• State that you expect a response within 8 weeks as required by FCA rules

Address the letter to the Complaints Manager, not a generic customer service address.

Step 4: Wait for Their Response (Up to 8 Weeks)

The insurer must acknowledge your complaint promptly and issue a final response within 8 weeks. If they uphold the denial, the final response letter must explain why, and it must tell you about your right to go to the Financial Ombudsman Service.

If you receive a final response you disagree with, or if 8 weeks pass without a final response, you can immediately escalate to the FOS.

Step 5: Escalate to the Financial Ombudsman Service

The FOS is a free, independent service that resolves disputes between consumers and financial businesses, including insurers. You must contact them within 6 months of receiving the insurer's final response letter.

To file with the FOS:

• Visit financial-ombudsman.org.uk
• Complete the online form or download a paper complaint form
• Include copies of all correspondence, your policy documents, and your evidence bundle

The FOS can award compensation of up to £430,000 for complaints referred after April 2024, and can direct the insurer to pay your claim, change their decision, and compensate you for distress and inconvenience.

Step 6: Consider Legal Action as a Last Resort

If the FOS doesn't resolve the matter in your favour, you can still pursue the insurer through the courts. Many solicitors offer insurance dispute cases on a no-win, no-fee basis. The FOS decision, while binding on the insurer (if you accept it), is not binding on you — you are free to reject it and litigate.

Common Mistakes to Avoid

Accepting the denial without reading the policy: Many people take the insurer's word for it. Always check the policy wording yourself.

Only calling, never writing: Phone calls don't create formal records. Always follow up verbal conversations in writing.

Missing the 8-week window: Once you receive the final response, you have 6 months to go to the FOS. Don't let this deadline pass.

Not including enough evidence: Vague complaints fail. Be specific, reference exact clauses, and attach documentary proof.

Waiting too long to start: Don't delay filing your internal complaint. Time-sensitive evidence like medical records or CCTV footage may become harder to obtain.

Accepting a lowball partial settlement without question: If the insurer offers partial payment, you can still dispute the amount that was denied.

The Financial Ombudsman Service: What to Expect

The FOS handles over 200,000 complaints per year. For insurance complaints specifically, they uphold the consumer's position in roughly 30-40% of cases — which means a meaningful proportion of denied claims are reversed on appeal.

The average investigation takes 3 to 6 months for straightforward cases. Complex cases involving medical evidence or large sums can take longer. You will be assigned a case handler who will contact both you and the insurer for information.

The process is entirely free for consumers. The insurer pays a case fee to the FOS regardless of outcome, which incentivises insurers to resolve complaints internally before they escalate.

What to Do If Your Insurer Has Gone Out of Business

If your insurer becomes insolvent, the Financial Services Compensation Scheme (FSCS) may cover your claim. FSCS covers:

• Compulsory insurances (e.g., motor, employer's liability): 100% of the claim
• Non-compulsory insurances: 90% of the claim with no upper limit

Contact the FSCS at fscs.org.uk if your insurer is no longer trading.

Specific Scenarios and Your Rights

Home Insurance Denied

If a home insurance claim is denied, request the insurer's survey report if they conducted one. Under FCA rules, they must share the basis of their decision. If they cite wear and tear, you may be able to demonstrate that the damage was sudden and accidental.

Life Insurance Denied

Life insurance denials often involve allegations of non-disclosure. If the insurer claims the deceased failed to disclose a health condition, they must prove the non-disclosure was deliberate or reckless. Innocent non-disclosure entitles the estate to a proportional remedy under the Consumer Insurance (Disclosure and Representations) Act 2012.

Travel Insurance Denied

If your travel claim is denied due to a pre-existing condition, check whether the condition was declared and whether the policy covered it. Many travel insurers offer medical screening, and if you passed screening, they cannot later use that condition as grounds for denial.

Getting Help with Your Appeal

Writing an effective appeal letter is one of the most important steps in this process. The difference between a vague complaint and a well-structured, evidence-backed appeal letter can determine whether your claim is overturned at the internal stage — avoiding months of waiting.

ClaimBack (claimback.app) is a free tool that generates professional insurance appeal letters tailored to your specific situation, your country, and the reason for denial. Answer a few questions about your claim and get a ready-to-send letter that references the correct regulations and frames your case effectively. It takes less than five minutes and costs nothing to use.

Summary

1. Read your denial letter carefully and identify the exact reason given
2. Gather evidence that directly addresses that reason
3. File a formal written internal complaint within 8 weeks
4. If unresolved, escalate to the FOS within 6 months of the final response
5. Use the FOS's free service — it has real power to overturn insurer decisions
6. Consider legal action if the FOS route doesn't succeed

You have more rights than you think. UK regulators take insurance complaints seriously, and insurers know that poorly handled complaints have regulatory consequences. Don't give up after the first denial.