My insurer refuses my claim, what now?

The short answer

Always start with a formal complaint to your insurer and request a written explanation of the refusal. If that doesn't help, you can file a free complaint with the Kifid (Financial Services Complaints Institute). The Kifid can make binding decisions up to €150,000. As a last resort, you can go to court, but this is costly and time-consuming. It's important to keep all correspondence and evidence carefully.

What does the law say?

Insurers must make payments in accordance with the policy conditions and may only refuse on valid grounds such as exclusions or non-compliance with obligations. They are obliged to provide a written justification for their refusal within a reasonable period. The Financial Supervision Act (Wft) stipulates that insurers must act with due care. In case of disputes, consumers can make use of the right to dispute resolution through the Kifid.

What should you look out for?

First, check your policy conditions yourself to understand why the insurer is refusing. Pay close attention to deadlines for filing objections or complaints. Make sure to document all communication in writing and keep all original documents. Be aware that some procedures may involve costs.

Example from practice

Jan has water damage due to a leaking washing machine, but his insurer refuses because they claim the maintenance was delayed. Jan files a formal complaint and asks for proof of their claim. The insurer cannot provide this. Through the Kifid, Jan eventually gets his damage compensated because the insurer could not properly justify the refusal. This process cost Jan no money and took about 3 months.

What can you do?

Follow these steps in order for the best chance of success: