My insurance claim has been denied – what can I do?

Claim Assist will review your declined claim and advise on the validity as well as the opportunity to have the file reopened and reviewed based on a submission that we can prepare for you.

Insurance claims advice: Do I really need this?

Insurance policies and insurance law are complex, specialist subjects. Google possibly has some answers for you, but why spend hours researching when one free telephone call can gain you peace of mind about challenging a declined claim, recovery from a third party for your uninsured loss or assistance at the Disputes Tribunal? 

Here are five reasons to have Claim Assist help you:

  1. We can review your claim and submit to the insurance company in a manner that will enable them to make a quick decision – in your favour.
  2. Each claim is unique: we can quickly identify any potential issues that may prejudice the claim process. We identify potential issues and address them based on many years of experience and technical knowledge.
  3. We can translate the complex technical and legal language into plain English for you, saving your time, eliminating frustration and maximising settlement.Claim Assist works for you, not the insurance company. 
  4. Claim assessors appointed by the insurance company may be “independent” but they are employed to settle claims at the lowest cost to the company.
  5. We will manage the claim for you, keep you fully informed, stress free and the decision to accept or decline  the offer we negotiate from your insurer is always yours.
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Why employ you when my insurance company has an independent assessor?

How independent is a company that relies on the insurer for their income? The assessor is engaged to determine if your claim is covered under the policy and then to mitigate the loss and arrange the settlement at the most advantageous terms to the insurance company. They do not represent your interests. For a small fee, we act as advocates and insurance law specialists to ensure you, the policyholder, receive the full entitlement under the contract of insurance.

What can I do if I’ve received payment but I’m not satisfied?

You may have received a part payment or you may have signed a letter of discharge accepting the payment from the insurance company as “full and final” settlement. There are circumstances where this “final” payment can be challenged, especially if the repairs are not up to an acceptable standard – contact us now to discuss.

Can my insurance company cancel my cover if I hire Claim Assist?

No. We are specialist advisors and are providing you with information that you, as a lay person, would not be expected to have. We act only on your behalf in a professional relationship to obtain a fair and speedy settlement from the insurer. We negotiate most claims settlements in a non-confrontational, non-adversarial manner.

Who can use your services?

We act for individuals, partnerships, bodies corporate, commercial enterprises, public listed companies and private businesses. Every claim arises through different circumstance and loss; we approach all claims with the same professional diligence regardless of the quantum.

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How will this affect my “in-hand” settlement?

Chances are, if you have found this page, you fall into one of these categories: 

  1. If your claim has been declined by your insurer or you are dissatisfied with the offer made to you, so there is nothing to lose. We will either confirm the amount offered is reasonable or, in the case of a declined claim, any amount we can obtain for you is greater than no insurance payment at all. 
  2. You may have a claim that is complex, time consuming or falls within an ambiguous policy clause. We can save you time and obtain the best settlement possible – remember, you will always have the final decision on accepting or continuing the negotiation of a claim. 

When successful, we will approach your insurance company for a contribution of the costs you have incurred with Claim Assist. Note, however, that not all companies will contribute and consider that any advocacy costs fall under your contractual requirement to prove your loss.

View the schedule of our affordable fees here >

I have repaired the damage and forgot insurance may cover this – can I still claim?

Most policies have a clause that you must have notified the insurance company and received their authority to repair at an agreed cost. However, there are circumstances where you may be able to seek reimbursement from the insurer, particularly if you have acted in good faith, have receipts or quotations or acted immediately to mitigate (minimise) the potential loss.

My friend advised I claim at the Disputes Tribunal – is this wise?

For claims under $15,000 that have been declined and where you feel you have a valid claim, this is an excellent idea. Solicitors are not permitted to represent clients at the Tribunal. In theory this produces a level playing field for participants, but not quite, as the major insurers have employees dedicated to attending the Tribunal on behalf of their employer. They are well versed in policy wordings, settlement terms and at ease in the adversarial environment. If you are confident, then this is an option you may consider. 

Claim Assist can prepare your files for you, draft your statement, argument and draft rebuttals to arguments the insurance company may raise. If required, we can attend the Tribunal with you and assist in the process, subject to the individual referee approval. If you would like assistance in preparing an uninsured recovery, defence or declined claim contact us now.

If you have any other questions not addressed on this site, don't hesitate to get in touch and ask us – the initial consultation is free.