How to complain about an insurance provider

Customers should follow a clear process when making a complaint about their insurer, starting with an informal complaint to the company themselves.

If this doesn't resolve the issue, we can make a more formal complaint or take our grievance to the Financial Ombudsman Service.

The last resort for unhappy insurance customers is the small claims court, but this could cost us money and there's no guarantee of success.

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How to complain about an insurer

There are four ways to deal with a complaint against an insurance company, each one a more formal step than the one before:

1. Contact an insurer informally about the complaint
2. Write to an insurer formally
3. Take the case to the Financial Ombudsman
4. Take the case to the small claims court

We'll examine these steps more closely below, but it's important to remember that following the process is crucial to get a satisfactory resolution to a complaint.

Remember, if you're unhappy with an insurance provider, switching insurer at renewal time is usually a good idea.

Step 1 - Informal contact

The first step for any complaint about an insurance company is to speak directly to them informally to try and resolve the issue.

This could be via:

• Email
• Online form
• Webchat
• Phone

If we speak to them on the phone, it's important to keep track of what was said and, ideally, follow up with an email to ensure there's a paper trail of communication.

It's important to be polite and friendly during these informal conversations, no matter how upset or frustrated we are.

The more reasonable and calm we are when we contact our insurance company, the more likely they are to try and help us with our complaint - anger not only stops us getting results, but it might also cause problems if we take our case further.

When contacting an insurer informally, make sure you have all your account information to hand plus the following:

• A short description of your complaint
• Date or event that the complaint relates to

In addition, if you believe the insurer's behaviour contravenes their own insurance policy, be ready to quote the policy to them.

Be sure to make a note of who you speak to, when the contact took place and what the outcome was. This will help if you need to take the complaint to the next step.

In some cases, this informal contact will resolve the issue, especially if the error was a genuine mistake on the part of the insurer.

If the informal conversation doesn't work, the next step is to make the complaint more formal.

Step 2 - Formal contact

Anyone unhappy with the informal response received from a customer service adviser over the phone, by email or through a webchat can then submit a formal complaint to their insurance company.

Every insurance provider must provide customers with a way of submitting a formal complaint. This information should be found on their website as well as any insurance policy documentation. If this isn't readily available, contact the insurer and ask for a copy.

A formal written complaint to an insurance company should be as clear as possible, but remember to include the following information:

• Your name and policy number
• Details of customer service advisers you have already spoken to about the complaint
• Explain the complaint clearly including all relevant details such as when it happened
• Include any evidence to support the complaint
• Explain why you're unhappy
• State what you would like the company to do to put things right
• Say that if you're unhappy with the way the insurer responds to the complaint that your next step will be to take the complaint to the Financial Ombudsman

Check your letter against the insurer's complaints procedures to make sure you've included everything they require then send it to the physical address or email address they say complaints should be directed to.

It's important to stick to the insurance company's complaint procedures as this allows us to say we have followed their requirements and our complaint should be considered.

Keep a copy of the letter and make a note of when it was sent.

Once the complaint is sent using the official complaints procedure of the provider, they have to respond within eight weeks.

If the response to the complaint isn't satisfactory (or the company doesn't respond within the eight-week timeframe), the next step is to take the complaint to the Financial Ombudsman.

Step 3 - Financial Ombudsman

The Financial Ombudsman Service (FOS) is a completely free service designed to resolve disputes between financial service providers and their customers.

Unhappy insurance customers can contact the Ombudsman for advice initially, but they are unable to act until eight weeks have passed or a response from the insurance company has been received.

When contacting the Ombudsman, they'll need the following information:

• Basic information such as your name and address
• Policy details including the policy number
• Details of the complaint and how you'd like things to be put right

If the complaint falls under the Financial Ombudsman Service's remit (as complaints about insurance companies do), they'll investigate.

This involves asking the insurance company for their version of events and then weighing up the facts of what happened.

The Ombudsman verdict will be fair and impartial - they're not on the insurer's side, but they may well find in favour of the insurance company. We've got more details on how often they do that later in this guide.

There could be several responses from the Financial Ombudsman:

• They could say the complaint was unjust
• They might find the complaint was the result of a misunderstanding between the insurer and the customer - if the customer hasn't lost out financially, this may be as far as it goes
• If they decide the customer was treated unfairly by the insurance provider, they can tell the business to put things right

Putting things right could mean the insurer paying compensation, but that isn't guaranteed. If the Ombudsman thinks the complaint is better resolved in a different way then that's what they'll recommend to the insurance company.

If either the complainant or the insurance company isn't happy with the Ombudsman Service's assessment, it's possible to ask for a final decision.

They'll look at the complaint afresh and then make a legally binding final decision.

If you're unhappy with the final decision, the Financial Ombudsman Service can't take the complaint any further, but there is one final step customers can take.

Step 4 - Small claims court

The final option for insurance complaints is to take the insurer to the small claims court.

However, there are two things to immediately note about this option:

1. If the Financial Ombudsman doesn't think the insurer has a case to answer to, it's worth asking realistically whether a court would contradict that
2. The small claims court isn't free in the way the Financial Ombudsman Service is and if you lose you won't get the money back - you could even be forced to pay expenses against the insurance company

Usually, if the Financial Ombudsman has taken the view that a complaint shouldn't receive compensation or redress, it'd be rare for the small claims court to find the opposite.

Think carefully before taking a complaint about an insurance company to the small claims court and recognise that it could be a costly last resort.

What do insurance customers complain about?

Now we've looked at the way insurance customers can make a complaint, it's worth pausing to understand why they might complain in the first place.

One of the most common reasons is due to a rejected insurance claim (and we cover that more detail below), but these are some other common reasons customers complain:

• Quality of repairs by an approved tradesman or garage
• Incorrect valuations of cars and home items
• Problems around renewal
• Difficulties with no-claims bonuses
• Insurer saying something can be repaired when you think it should be replaced

These are just examples, and there are other reasons insurance customers may complain.

Our guide on mental health and insurance explains why some customers may be unhappy with clauses in their insurance policies.

Rejected insurance claims

If an insurance claim is rejected, customers have the right to follow the procedures in this guide to challenge the decision.

Claims can be rejected for various reasons, but these are three of the major ones:

1. The customer gave incorrect information about their claim
2. The customer didn't take due care and that led to why they're making a claim
3. The customer was untruthful and inaccurate when they originally took out their insurance policy

These reasons for rejection underline the importance of being truthful at all times when making a claim for car insurance or any other type of policy.

Insurance companies aren't necessarily trying to trip us up, but they do want to be confident they're paying out on a legitimate claim.

If a claim is rejected, there are steps customers can take to understand whether the insurer was within their rights to reject it before making informal contact as we outlined at the beginning of this guide.

First, check the details of the insurance policy to see if the rejection reason matches up with what's in your policy documentation. Ask yourself the following questions:

1. Did you give the correct details when you set up the policy?
2. Is there wording within the policy that says you're covered for the type of claim that was just rejected?
3. Is the wording ambiguous or poorly explained? Documentation from insurance companies in the UK needs to be clear.
4. Did the insurer fail to ask a question during the application process which would have changed their decision now? If they say something should have been voluntarily disclosed but you didn't know that it could be the backbone of a successful complaint.
5. Did you notify the insurer of a change of circumstances, but they haven't reflected that in your policy?

These are all valid reasons to make a complaint against an insurance company but be honest with yourself about whether the claim is valid - it will save you time and energy if you avoid speculative claims.

Read our guide to home contents insurance to understand what might be covered by a policy and what you should be looking out for when signing up.

There are also some policies that specifically exclude flood risks - our guide to flood risk and insurance has more on that.

Financial Ombudsman data

Looking at the data provided by the Financial Ombudsman Service, we can see how many cases they uphold in favour of the complainant.

This is how many enquiries were received during the year to 31 March 2022, along with the number of new cases opened and the number upheld in that financial year:

As we can see from looking at this data, the Ombudsman Service deals with thousands of complaints every year about home and motor insurance, yet they find in favour of the insurance company more often than the customer and these uphold rates are generally consistent from year to year.

For contents and motor insurance, just over a quarter of complaints were upheld in 2021/22, although this rose to 33% for buildings insurance complaints.

Pet insurance, while not covered in the table, had a 25% uphold rate, lower than we've seen in previous years.

So, overall, we don't see a huge trend of the Financial Ombudsman Service overturning the judgement of insurance companies themselves.

As insurance customers with a grievance, then, we should be prepared for the Financial Ombudsman Service to side with the insurance company.

In such circumstances, it's worth reading their analysis carefully before deciding to take the complaint further - their explanation of why they rejected a claim will usually be detailed enough for customers to understand why they made that decision. While we may not agree with them, their reasoning will normally be legally correct.

Summary: Stick to the process

If we're unhappy with an insurance company, we have the right to complain, but it's important we follow the right process to ensure we've got a chance of being successful.

For many customers, discussing the problem informally or formally with an insurer will resolve the problem. However, the Financial Ombudsman Service offers a valuable backup to settle disputes between customers and insurers.

There are a couple of elements to making a successful insurance claim:

1. Understanding your insurance policy
2. Being clear about why you think you have been poorly treated
3. Following the correct complaints procedure

Most of all, be honest and polite at every stage of the process - it makes you easier to deal with and insurers are more likely to work with a complainant who is friendly than one who yells at their staff.

Find out more about insurance policies in our guides to comprehensive car insurance and cheaper motorbike insurance.