Legal & General Insurance Claim Denied: How to Appeal in the UK

Legal & General (L&G) is one of the UK's largest and most established financial services groups, with a history dating back to 1836. L&G is a major provider of life insurance, critical illness cover (CIC), income protection insurance, and mortgage protection insurance for millions of UK individuals and families. When L&G denies a claim, the financial consequences can be severe — but L&G's decisions are not final. The Financial Ombudsman Service (FOS) provides an independent, free route to challenge wrongful denials.

Why Insurers Deny Legal & General Claims

L&G's denial patterns across its protection product range follow predictable categories:

• Non-disclosure allegations — L&G's most common denial type; it alleges the policyholder failed to disclose relevant medical information when applying (non-disclosure or misrepresentation); under the Insurance Act 2015 and CIDRA 2012, the law distinguishes between deliberate/reckless misrepresentation (which can void the policy) and innocent/careless non-disclosure (which allows only a proportionate remedy, not automatic voiding)
• Critical illness definition disputes — L&G defines each covered condition precisely in the policy; disputes arise when your condition does not exactly meet L&G's definition (cancer staging, heart attack troponin thresholds, stroke residual symptom requirements)
• Income protection disability disputes — L&G may argue you are not sufficiently unable to work; disputes frequently arise about the definition of disability (own occupation vs. any occupation) and termination of ongoing payments based on independent medical examination (IME)
• Pre-existing condition exclusions — If L&G claims the condition that triggered the claim existed before the policy started and was not disclosed, the claim may be denied based on the pre-existing condition exclusion
• Suicide clause — Most L&G life policies exclude suicide within the first 12 months; after 12 months, suicide is typically covered; disputes arise about classification of cause of death
• Beneficiary claim delays — Claims made by beneficiaries may face delays or denials when L&G disputes the validity of the policyholder's application or the beneficiary's entitlement

Under the Consumer Insurance (Disclosure and Representations) Act 2012 (CIDRA) and the Insurance Act 2015, you have significant legal protections against L&G's non-disclosure allegations.

How to Appeal a Legal & General Denial

Step 1: Request the Full Written Denial Explanation

Ask L&G to provide a detailed written explanation citing the specific policy clause relied on, the factual basis for the denial, and any medical evidence they reviewed. If L&G is alleging non-disclosure, ask exactly what they claim was not disclosed, when they believe you became aware of it, and why they consider it material to the claim.

Step 2: Obtain Your Complete Medical Records

For non-disclosure disputes: request your complete GP records and hospital records covering the period before the policy was taken out. Review whether L&G's characterization of your medical history is accurate. Obtain a letter from your GP clarifying your medical history at the time of application and what you would reasonably have been aware of.

For critical illness disputes: obtain a detailed letter from your treating specialist explaining the clinical details of your diagnosis and whether — in their clinical opinion — it meets L&G's specific policy definition. The policy wording itself (not the marketing summary) is what controls; have your specialist review the exact definition language.

Step 3: Review Your Rights Under CIDRA 2012 and the Insurance Act 2015

Under CIDRA (for policies taken out after April 2013), you must take reasonable care not to misrepresent your circumstances when applying. You are not required to volunteer information beyond what is asked. If your non-disclosure was innocent (not deliberate or reckless), L&G's only available remedy is proportionate — they may adjust the payout but cannot automatically void the policy. If L&G never asked about the relevant condition in the application form, you generally had no duty to disclose it.

Step 4: File a Formal Complaint With L&G

Contact Legal & General at 0370 010 4080 (life insurance claims) or through their online portal at legalandgeneral.com. Clearly state you are making a formal complaint, reference your policy and claim numbers, and state the specific outcome you are requesting. Attach all supporting medical evidence. L&G must acknowledge your complaint within 5 business days and issue a Final Response within 8 weeks.

Step 5: Escalate to the Financial Ombudsman Service (FOS)

If L&G's Final Response does not resolve your complaint, or if 8 weeks pass without resolution, refer your case to the FOS at financial-ombudsman.org.uk or call 0800 023 4567 (free). File within 6 months of L&G's Final Response. The FOS is particularly effective for non-disclosure disputes where the misrepresentation was innocent, critical illness definition disputes (FOS applies a fairness standard), and income protection disability disputes.

Step 6: Consider Legal Action for High-Value Claims

For very large claims or clear policy breaches, consult a solicitor specializing in insurance disputes. Many work on conditional fee (no win, no fee) arrangements for insurance dispute cases.

What to Include in Your Appeal

• L&G's written denial letter with the specific policy clause and factual basis identified
• Your policy number, claim number, and relevant policy document (not the marketing summary — the actual policy wording)
• Complete GP records and hospital records for the period before policy inception (for non-disclosure disputes)
• GP letter clarifying your medical history and awareness at the time of application
• Treating specialist's letter addressing whether your condition meets the specific policy definition (for critical illness disputes)
• Independent functional capacity evaluation or neuropsychological assessment (for income protection disputes)

Fight Back With ClaimBack

Legal & General is one of the UK's most established insurers, but its denials are not final. Whether you are disputing a critical illness payout, challenging a non-disclosure allegation under CIDRA, or fighting an income protection termination, the FOS process is free and gives you real independent review. ClaimBack generates a professional appeal letter in 3 minutes. Start your free claim analysis → Free analysis · No credit card required · Takes 3 minutes

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• How to Write an Insurance Appeal Letter
• What Is Medical Necessity?
• Internal vs External Insurance Appeal