When a Claim is Rejected: Next Steps

Understanding why your claim was declined

Receiving a rejection letter can be frustrating, but it is the starting point for your appeal. Insurers must provide a clear reason for their decision, often referencing specific terms and conditions found in your policy wording. Common reasons for rejection include failure to disclose a pre-existing medical condition, being under the influence of alcohol during an incident, or travelling to a destination against Foreign, Commonwealth & Development Office (FCDO) advice. Understanding the exact clause used to deny the claim allows you to build a targeted response.

• Non-disclosure of medical history or health changes
• Lack of reasonable care (e.g. leaving bags unattended)
• Incidents involving alcohol or illegal substances
• Travelling against FCDO safety warnings
• Failure to obtain a police report within 24 hours
• Claiming for items without original receipts or proof of ownership

What is covered during an appeal

The appeals process covers any claim that you believe has been unfairly rejected or where the insurer has misinterpreted the facts of the situation. This includes disputes over the valuation of lost items, the necessity of medical treatments abroad, or the validity of a cancellation reason. The Financial Conduct Authority (FCA) requires insurers to treat customers fairly, meaning they must consider any new evidence you provide during the internal review stage. If your appeal is successful, the insurer will typically pay the original claim amount plus interest in some cases.

Common exclusions and 'gotchas'

Some rejections are difficult to overturn because they involve standard industry exclusions. For example, most policies will not cover 'change of mind' cancellations or claims arising from reckless behaviour. Many travellers are unaware that 'unattended' has a very strict definition in insurance terms; leaving a bag with a friend or in a locked car boot might still lead to a rejected theft claim. Additionally, if you did not use your Global Health Insurance Card (GHIC) in an EU country when required by your policy, the insurer may reduce the payout or reject the medical expense claim entirely.

The cost of travel insurance and claim values

The price of your premium often reflects the level of cover and the likelihood of a payout. In 2026, a standard one-week policy for a healthy traveller to Europe typically costs between £15 and £45, whereas policies for those with pre-existing conditions or those travelling to the USA can exceed £150. When a claim is rejected, the financial impact can be significant, especially for medical emergencies which can easily reach £50,000 or more in North America. Understanding the value of your claim helps determine if escalating the case to the Ombudsman is a proportionate response.

• Standard European cover: £15-£45 per week
• Worldwide cover (including USA/Canada): £60-£180
• Average medical claim value: £1,500-£3,500
• Major air ambulance repatriation: £15,000-£80,000
• Excess amounts: typically £50-£250 per person

Choosing the right policy to avoid future rejections

Prevention is better than an appeal. When choosing a policy, honesty is paramount, particularly regarding medical screening. Use tools like MoneyHelper to find specialist insurers if you have complex health needs. Ensure the policy limits for cancellation and baggage match the actual value of your trip. If you are heading to the EU, ensure you have a valid GHIC or EHIC, as this can waive your policy excess for medical claims. Always check that your destination is not on the FCDO 'red' or 'amber' list for non-essential travel before you depart.

Gathering evidence for a successful appeal

The strength of your appeal depends on the documentation you provide. If a claim was rejected due to a medical non-disclosure, a letter from your GP confirming that the condition was not known or relevant at the time of booking can be vital. For theft claims, a crime reference number is mandatory. If the dispute is about a flight delay, obtain a written statement from the airline. Keep a log of all phone calls and copies of all emails sent to the insurance company to track your progress and ensure you meet all deadlines.

• Original receipts, bank statements or valuations
• Official police reports or 'Property Irregularity Reports'
• Medical records and GP letters
• FCDO travel advice screenshots from the date of travel
• Photographic evidence of damage or signage
• Detailed timeline of the incident and claim history

The role of the Financial Ombudsman Service

The Financial Ombudsman Service (FOS) is a free, independent body that settles disputes between UK consumers and financial organisations. You can only contact them after you have received a 'final response letter' from your insurer or if eight weeks have passed since you first complained. The FOS will look at whether the insurer followed the law and industry best practices. They have the power to force the insurer to pay the claim and can award compensation for any distress or inconvenience caused by the initial rejection.

Practical checklist for your appeal

Before submitting your formal complaint, ensure you have completed these steps to give yourself the best chance of success. Accuracy and detail are your best tools when dealing with a claims department. Remember that the insurer has a duty to be clear and not misleading in their policy documents; if a term is ambiguous, the FOS often rules in favour of the consumer. Follow this checklist to ensure your appeal is robust and ready for review by the insurer or the Ombudsman.