How to Resolve Insurance Issues

If you make an insurance claim and experience any problems, or have concerns about your insurance policy, there is a simple procedure that should rectify any difficulties. If you are unable to seek a shift, satisfactory solution to the problem, however, there are a number of other options available.

What To Do

• Write to your insurance provider.
• Give clear details of the problem, concern or complaint. It is also beneficial to you if you state how you would like the matter to be resolved.
• If you are not satisfied with your insurance company’s response to your problem, it is time to make a formal complaint. Use the insurance company's official complaints procedure when stating your dissatisfaction formally. Doing this will stand you in good stead should the matter continue to be disputed.
• If you are still not satisfied with the official response you are then able to consider taking the matter even further, to the Financial Services Authority (FSA). All insurance providers should be covered by the rules of this financial watchdog.
• You can take your complaint to the Financial Ombudsman Service. This service is free to policyholders who have already followed the insurance company's set complaints procedure.

What Happens Next

The Financial Ombudsman Service will try to resolve the situation on your behalf using mediation. If this does not result in the complaint being resolved the Financial Ombudsman Service will now start a formal investigation. The final decision of this investigation is binding on the insurance provider. However, if you are still dissatisfied with the outcome you are now able to take the insurance company to court.

Legal action is an option if a policyholder has not been offered a satisfactory outcome. If your insurance provider is based outside the UK you can also take the company to court for resolution. Going to court should always be seen as the last option, as any compensation offered by a court could be reduced if you have failed to try other channels to resolve the complaints issue.

Other Options

If you have a complaint that has not been satisfactorily resolved through negotiation you may consider using an alternative dispute resolution (ADR). A third party, or arbitrator, can help you with your complaint.

This service usually carries a fee, which may be refunded if your complaint is successfully resolved. Using an ADR scheme is legally binding, which means that you will not be able to pursuit your complaint in court at a later date.

There are three main types of ADR available – conciliation, mediation and arbitration:

Conciliation

This is the first stage, where the policyholder and insurance company are given written details of the complaint, and the best outcome is looked at. Any decision made at this stage is not legally binding, so you will be able to continue to arbitration or consider taking the case straight to court.

Mediation

This involves negotiation between a mediator, insurance provider and policyholder. Written details of the complaint are exchanged and any evidence brought forward. If there is an agreement the policyholder and insurance company will have to meet to draft the terms of the resolution. Unless you state otherwise, this decision will be legally binding.

Mediation can be a costly service to use, but it is worth considering if you are able to get legal aid, or if you are unable to reach a satisfactory settlement by any other means.

Arbitration

Following this route means that the policyholder, and insurance company, will have to agree to accept the decision that is made by the arbitrator. Court action, at a later stage, will also not be possible, unless it is to enforce the payment of awarded compensation. This service carries a fee.