There are always options. What do you do next when the insurance company rejects your car insurance claim? We share some important tips for how to appeal a car insurance claim decision.
Vehicle insurance policyholders are usually met with a sweet kind of relief after an accident when they remember they have car insurance (obviously, this feeling usually comes after the dust has settled a bit). But if you’re not hurt and your insurer is going to pay for the damages, you’ll agree that you are in a relatively good position.
Until you receive your notice stating that unfortunately, your claim has been rejected. Your mind starts going 150km an hour whilst you start trying to remember if the accident happened because YOU were driving 150km/h.
A few reasons why your claim may have been rejected:
- You haven’t paid your premiums on time.
- Non-disclosure.
- An unlicensed or unspecific driver was driving your car.
- You were inebriated or under the influence.
- Your vehicle is unroadworthy.
- You didn’t securely park your car at night.
- You don’t have write-off cover (not an issue with Oneplan – we offer comprehensive insurance that always covers total losses).
- You did not adhere to all terms and conditions of your contract as stipulated in your policy wording.
- You weren’t 100% honest with your insurer regarding the information you provided about the incident.
- You were claiming for a non-covered event.
- Your claim falls within excess – this means that the amount you are claiming for is less that the pay-out amount.
So, is it the end of the road?
It doesn’t have to be. If none of the above conditions apply to you and you feel that your claim has been unfairly rejected, it is possible to appeal the decision using the appeal process tips listed below.
How to Appeal a Car Insurance Claim Decision
A quick note on the process to follow when appealing a claim with Oneplan: the contact avenues available to you will be sent to you in documented format and explained verbally by an agent once a decision has been reached on the outcome of the claim. You can then follow the steps below.
1. Know your policy
If you haven’t got a really good grasp on your policy and exactly what you’re covered for, your policy document needs to be your first stop. You don’t want to go in guns blazing just to find that your skim reading caused you to miss a few important points. If an exclusion is outlined in your policy, you will have to accept the rejected claim.
A big part of our mission is to provide comprehensive car insurance that’s jargon-free and easy to understand.
2. Get in touch
Once you’ve reacquainted yourself with your policy and you still aren’t satisfied, you should get in touch with your car insurance company. Insurers are protocol gurus and will have a formal complaints system (required by law) to ensure the entire process is transparent and efficient. This will help you get an official reason for why your claim was rejected.
We would recommend getting in touch via written complaint as it is easy to document and keep a record of.
3. Tell the truth and state the facts
You need to remember that the way you communicate after your claim has been rejected is very important. Firstly, approach your insurer in a calm and objective fashion. It will be detrimental to your case if your story keeps changing or if emotions are running too high. To make yourself well understood, you need to state your case clearly with all the facts and necessary information in place.
4. Get an outsider’s perspective
You have the option of pursuing an individual assessment. This means hiring someone to objectively assess the situation with a fresh perspective. These people are known as independent loss adjusters and will have to be paid for by you, not your insurer.
5. Go to the Ombudsman
If you still feel that your claim has been unfairly rejected, you can go a step further. An Ombudsman is a free authority that assists individuals in approaching large companies or organizations and by investigating their claims.
Get in touch with a short-term Ombudsman, file your complaint, and they will then be in touch with your insurer. Please note that using the services of an Ombudsman is only applicable to short-term loans like home and car insurance.
6. Call your lawyer
Seeking legal advice might be your next best bet. An Ombudsman will base their advice and research around the law, but they cannot advise you legally. If you believe you have cause to take your insurer to court, you’ll need to hire an attorney.
Of course, nobody ever wants to reject a claim. Take it from the other side of the fence, it’s not a good time. We try to be as transparent and communicative as possible to make sure nobody is ever caught by surprise if their claim is rejected.
Please contact us if you have any questions about your policy, exclusions, or what you’re covered for. We’re here to help explain your plan to you!
Your Insurance Family,
Oneplan
