Can an insurer refuse a claim for something I forgot to mention?

Only if the misrepresentation was careless or deliberate and actually made a difference to the cover offered. An innocent, immaterial omission should not defeat a consumer claim.

How long do I have to complain?

Normally six months from the insurer's final response to take it to the Financial Ombudsman, and six years from the event to complain to the insurer.

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Free insurance claim rejection appeal letter template

Challenge an insurer that has declined, reduced or delayed your claim. This letter asks for the specific policy wording relied on, answers it, and puts the insurer on notice of a Financial Ombudsman referral.

Who this letter is for

Appeal a rejected or underpaid insurance claim before going to the Ombudsman. It is written in the formal register companies, landlords and card issuers expect, and it records the facts, the remedy sought and the deadline in a way that supports any later escalation to an ombudsman or the courts.

How to use this template

1Read the rejection letter and note every reason given.
2Download the template and answer each reason separately and factually.
3Ask the insurer to quote the exact clause and page it relies on.
4Attach repair quotes, photographs and your policy schedule.
5After eight weeks or a final response, refer the complaint to the Financial Ombudsman Service.

What to include before you send it

Ask the insurer to quote the exact clause and page it relies on to decline.
Answer each reason for rejection separately and factually.
Insurers must not decline for an innocent misrepresentation that made no difference.

The rights you are relying on

Insurance Act 2015 and Consumer Insurance (Disclosure and Representations) Act 2012, FCA ICOBS claim-handling rules, and the Financial Ombudsman Service.

The letter template

[Your name]
[Your address]
[Email address] · [Phone number]
Policy number: [POLICY NO] · Claim number: [CLAIM NO]
[Date]

Complaints Department
[Insurer name]
[Address]

Re: Formal complaint and appeal against claim decision — claim [CLAIM NO]

Dear Sir or Madam,

On [DATE] I made a claim under policy [POLICY NO] in respect of [describe the loss or damage briefly]. On [DATE] you [declined the claim / offered [AMOUNT], which does not cover my loss of [AMOUNT]].

I appeal against that decision on the following grounds:

[Choose and complete:
- The exclusion you rely on does not apply on these facts, because [explain];
- The information you say I failed to disclose was [not asked for / immaterial / provided on [DATE]], and any misrepresentation was innocent and made no difference to the terms you offered;
- Your settlement figure does not reflect the cost of [repair / replacement], evidenced by the quotes enclosed at [AMOUNT];
- The claim has not been handled promptly: it has been [X] weeks since I provided all requested evidence.]

Please provide, within 14 days, the exact policy wording and clause number relied on, the evidence you say supports it, and your final response.

I ask you to reconsider and pay the claim in full at [AMOUNT], together with interest and my reasonable costs. If I do not receive a satisfactory final response within eight weeks, I will refer this complaint to the Financial Ombudsman Service, which is free for me to use and can award redress.

Yours faithfully,

[Your name]

Enclosures: policy schedule, quotes, photographs, correspondence.

Frequently asked questions

Can an insurer refuse a claim for something I forgot to mention?: Only if the misrepresentation was careless or deliberate and actually made a difference to the cover offered. An innocent, immaterial omission should not defeat a consumer claim.
How long do I have to complain?: Normally six months from the insurer's final response to take it to the Financial Ombudsman, and six years from the event to complain to the insurer.

Turn this example into your own formal letter

The £0.59 option creates one formal letter using your names, dates, sums and evidence. The £3.99 Case File also includes an email, evidence checklist, action plan and follow-up notice.

Uses the facts you provide Includes a clear response date

Personalise this letter — £0.59

Or read more about our personalised insurance appeal.

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