UK Life Insurance Claim Denied? How to Appeal

Losing a loved one is devastating enough. Discovering that a life insurance claim has been denied makes an already painful time even harder. UK life insurance claims are refused for a variety of reasons — including allegations of non-disclosure, exclusion clauses, or disputes about the cause of death. But many of these denials are challengeable, and the Financial Ombudsman Service overturns a significant proportion of them.

This guide explains why UK life insurance claims are denied and what steps you can take to fight back.

Why UK Life Insurance Claims Are Denied

Non-Disclosure

This is by far the most common reason for UK life insurance claim refusal. Insurers allege that the deceased failed to accurately disclose their medical history at the time of application. Common non-disclosure disputes involve:

• Undisclosed pre-existing medical conditions
• Failure to disclose smoking status
• Inaccurate reporting of alcohol consumption
• Not disclosing previous mental health treatment
• Omitting information about hazardous occupations or hobbies

Under the Insurance Act 2015, insurers cannot simply void a policy for any non-disclosure. The Act requires a proportionate remedy — meaning that if a non-disclosure was inadvertent and would not have changed the insurer's underwriting decision, the insurer cannot refuse to pay the full claim.

Suicide Exclusion

Most UK life insurance policies exclude death by suicide within the first 12 to 24 months of the policy. After this exclusion period, suicide is typically covered. If the insurer is refusing a claim based on suicide, check whether the exclusion period has passed and whether the cause of death has been definitively determined.

Cause of Death Linked to an Excluded Activity

Some policies exclude death resulting from:

• Hazardous activities (e.g., skydiving, motor racing)
• War or civil unrest
• Drug or alcohol abuse

If the insurer claims the cause of death relates to an excluded activity, you have the right to challenge the factual basis of that claim.

Policy Had Lapsed

If premiums were not paid and the policy lapsed before the death, the insurer is entitled to refuse the claim. However, check whether the insurer gave proper notice of the lapse, whether a grace period applied, and whether any reinstatement options were available.

Misrepresentation vs Non-Disclosure

Intentional misrepresentation and inadvertent non-disclosure are treated differently under the Insurance Act 2015. Intentional or reckless misrepresentation allows the insurer to void the policy. Innocent or careless non-disclosure requires a proportionate remedy — which may mean a reduced payout but not necessarily zero.

Your Rights Under the Insurance Act 2015

The Insurance Act 2015 significantly strengthened policyholder protections:

• Insurers must ask clear questions — ambiguous questions are interpreted against the insurer
• The remedy for non-disclosure must be proportionate to what the insurer would have done had it known the truth
• Insurers cannot automatically void a policy for any non-disclosure

The FCA also requires insurers to handle complaints fairly and process them within eight weeks before referring to the FOS.

Step-by-Step: Challenging a Denied Life Insurance Claim

Step 1: Obtain All Documentation

Request from the insurer:

• The complete policy documents including application form
• The denial letter with specific reasons
• Any medical evidence the insurer relied upon
• The underwriting decision record (you may need to request this formally)

Step 2: Obtain the Deceased's Medical Records

You can apply to access the deceased person's medical records as their legal representative (executor or administrator of the estate). These records will allow you to:

• Check whether the information on the application form was accurate based on what the deceased knew at the time
• Identify whether any non-disclosure was innocent rather than deliberate

Step 3: File a Formal Complaint

Write to the insurer's complaints department, clearly stating this is a formal FCA complaint. Address each denial reason with specific evidence and legal arguments:

• Cite the Insurance Act 2015 if alleging disproportionate remedy
• Challenge the accuracy of any factual claims
• Provide medical evidence where relevant

Step 4: Escalate to the Financial Ombudsman Service

If the response is unsatisfactory, refer to the FOS within six months of the insurer's final response letter. The FOS is experienced in life insurance disputes and frequently overturns denials based on:

• Disproportionate non-disclosure remedies
• Ambiguous application questions
• Incorrect determination of cause of death
• Unfair application of exclusion clauses

Fight Back With ClaimBack

ClaimBack helps bereaved families challenge denied life insurance claims, navigating the Insurance Act 2015 framework and FOS processes with professional appeal letters tailored to your case.

Start your life insurance appeal with ClaimBack

Related Reading

• How to Write an Insurance Appeal Letter
• Common Reasons Insurance Claims Are Denied
• How to Use the Insurance Ombudsman