Insurance Complaint Routes

Start by submitting a formal written complaint to your insurer's complaints team. Most insurers have a dedicated complaints email address or online form. Your complaint should clearly state:

• Your policy number and the type of insurance
• The specific decision you are disputing — a rejected claim, an unfair settlement offer, a premium dispute, or service failure
• The evidence supporting your position — repair estimates, valuations, medical evidence, photographs
• What outcome you are seeking — full settlement, revised offer, explanation

Under FCA rules, insurers must acknowledge complaints promptly and issue a final response within 8 weeks. If they have not responded within 8 weeks, or if you are unhappy with their final response, you can refer to the Financial Ombudsman Service (FOS).

The FOS handles complaints about all FCA-regulated insurance products, including home, motor, travel, life, critical illness, income protection, and pet insurance. The FOS is free to use and its decisions are binding on the insurer if you accept them.

Common insurance complaints the FOS investigates include:

• Rejected claims where the insurer says an exclusion applies
• Undervalued settlement offers for damaged or stolen property
• Delays in settling valid claims
• Insurers cancelling policies or voiding them on grounds of alleged non-disclosure
• Premium disputes, including unexpected increases or charges

You must have received a final response letter (or waited 8 weeks) before the FOS will accept your referral. You have 6 months from the final response date to refer.

Strong evidence is essential for a successful insurance complaint. Gather:

• Your original policy document and any endorsements or schedule changes
• The claim form you submitted and all correspondence with the insurer
• The insurer's rejection or settlement letter, with their stated reasons
• Independent evidence challenging the insurer's position — for example, an independent surveyor's report, a second repair quote, or a specialist medical opinion
• Any representations made by the insurer (or a broker) when you took out the policy

If the insurer is relying on a policy exclusion, read the exact wording carefully. Ambiguous exclusion clauses are generally interpreted in the policyholder's favour under the Consumer Insurance (Disclosure and Representations) Act 2012 and the Insurance Act 2015.

Life insurance and income protection complaints are among the most serious and financially significant insurance disputes, often arising at a time of personal crisis. Understanding the specific complaint routes and common grounds for challenge is important.

Life insurance complaints most commonly arise from: the insurer refusing to pay out on a claim (often on grounds of alleged non-disclosure of a medical condition); delays in processing a death claim; disputes about the correct policy amount or the beneficiary designation; and policies lapsed due to alleged non-payment of premiums. Insurers frequently attempt to rely on non-disclosure of pre-existing medical conditions, but under the Consumer Insurance (Disclosure and Representations) Act 2012, they can only avoid a policy if you made a misrepresentation that was "careless" or "deliberate or reckless". Where a GP or insurer failed to ask relevant questions or the condition was genuinely forgotten, the misrepresentation defence may not apply. The Financial Ombudsman Service takes a rigorous approach to non-disclosure defences in life insurance claims.

Income protection insurance — sometimes called permanent health insurance or salary protection — pays a regular income if you are unable to work due to illness or injury. Common complaints include: the insurer taking an unduly narrow definition of "unable to work" in assessing claims; the insurer repeatedly requesting medical evidence and delaying payment; "own occupation" versus "any occupation" definition disputes; and exclusions for pre-existing conditions applied more broadly than the policy wording justifies. When complaining about an income protection refusal, obtain a clear written explanation of the specific policy wording the insurer relies upon, and consider obtaining an independent medical opinion if the insurer's assessment of your ability to work is disputed.

How to complain: Complaints about life insurance and income protection follow the same route as other insurance complaints — formal written complaint to the insurer's complaints department, then escalation to the Financial Ombudsman Service if unresolved within 8 weeks or if the final response is unsatisfactory. Given the sums involved, consider whether an independent financial adviser or a specialist insurance solicitor could add value in presenting your case before FOS referral. Citizens Advice can also provide initial guidance on the strength of your complaint.