Making a Claim
The exclusions page is the policy
Cover is defined by what it refuses to pay for. Reading the schedule first tells you more than any summary.
Rhiannon Blake
Editor, Insured and Ready
Rhiannon edits Insured and Ready and spent eleven years handling claims before deciding the explanations were the useful part.
Contact Rhiannon through our contact page — mark your message for their attention and it will be passed on.
44 articles
Making a Claim
Why a claim gets declined, in order of frequency
Declined claims cluster into a handful of causes, and nearly all of them are decided long before the loss happens.
Motor
The excess is the most under-used lever on a policy
Raising the excess lowers the premium immediately, and most policyholders would never have claimed for that amount anyway.
Life & Income
Term life cover is simple, and that is the point
Most people need a fixed amount for a fixed period. Almost everything more complicated is solving a different problem.
Making a Claim
Auto-renewal is where insurance quietly gets expensive
Renewal pricing is not a reward for loyalty. In most markets it is the opposite, and it compounds silently.
Health Cover
Chronic conditions are the boundary private health cover will not cross
Private medical policies are built to pay for episodes that end. A condition that never ends sits on the other side of the line.
Health Cover
Why health premiums rise every year even when you never claim
Three separate forces push medical premiums up, and only one of them has anything to do with you.
Home & Contents
New for old, or indemnity with wear and tear deducted
Two settlements for the same stolen jacket can differ by most of its value, and the difference is one phrase in the schedule.
Health Cover
Mental health is where private medical cover is narrowest
Cover for psychiatric treatment is usually capped in days, sessions or money, and is the section that varies most between insurers.
Home & Contents
Flood cover, flood zoning and the pools that make it available
Flood is the peril where private insurance most often stops working on its own, which is why several countries have built shared…
Home & Contents
Sheds, fences and gates: what outbuildings actually means
The garden is where home cover thins out. Fences, gates and hedges are excluded from storm damage in a great many wordings.
Home & Contents
Home emergency and legal expenses: what the add-ons really do
Two of the most-sold policy extras solve narrower problems than their names suggest, and both are worth understanding before…
Motor
Windscreen claims have their own excess and their own rules
Glass cover sits outside the main policy in most respects, with a separate excess, a separate no-claims treatment and an approved…
Motor
Why a non-fault claim still raises your premium
You did nothing wrong, the other driver paid, and your renewal went up anyway. That is a rating outcome, not an error.
Motor
Uninsured and untraced drivers: what happens to your claim
Being hit by someone with no insurance is common enough that most countries have built a mechanism for it. What that mechanism pays…
Life & Income
Critical illness pays on definitions, not on diagnoses
Two people with the same illness can get opposite answers from the same policy, because the contract measures severity rather than…
Life & Income
Level cover shrinks every year that prices rise
A sum assured fixed thirty years ago buys what a much smaller sum buys today. Indexation is the option that stops that happening…
Life & Income
Family income benefit pays a wage, not a windfall
A protection policy that pays monthly instead of as a lump sum is cheaper, easier to plan around and largely ignored by the market.
Life & Income
Waiver of premium keeps the policy alive when you cannot pay
The rider that pays your protection premiums during long-term illness costs very little and prevents the specific failure…
Life & Income
Why a life insurance payout can take months
The delay after a death claim is usually administrative rather than adversarial, and most of it can be prevented by decisions made…
Making a Claim
Indemnity means putting you back, not making you better off
One principle underlies most general insurance settlements, and understanding it predicts almost every offer you will ever receive.
Making a Claim
Proximate cause decides which peril pays
When a loss has several causes in sequence, the policy responds to the dominant one, and identifying it can be the whole argument.
Making a Claim
The loss adjuster works for the insurer, and that is not a scandal
Understanding who is paid by whom, and what each party is actually deciding, makes a claim visit far easier to handle.
Making a Claim
Subrogation: why your insurer chases someone else after paying you
Once a claim is paid, your right to recover from whoever caused the loss usually transfers to the insurer, and that transfer has…
Making a Claim
Cash settlement or insurer repair: the choice has a price
Taking money instead of a managed repair feels like freedom, and it usually costs a meaningful share of the settlement.
Making a Claim
When a decline is not final: complaints and independent review
A first decision is a company's view, not a verdict. In most regulated markets there is a structured route past it, and it costs…
Health Cover
Moratorium underwriting settles your history at the claim, not at the sale
A moratorium policy asks almost nothing when you buy it. The questions arrive later, once you have already had the treatment.
Health Cover
Switching health insurers without restarting your medical history
Moving to a cheaper health policy can quietly re-exclude everything you have been treated for. Continuity underwriting is the…
Health Cover
Specialist fee schedules and the shortfall nobody budgets for
Insurers pay consultants against their own price list. When the consultant charges more, the difference becomes a bill addressed to…
Health Cover
Area of cover is the map your health policy pays inside
International medical plans are priced by geography. The zone on your certificate decides whether treatment abroad is covered or…
Home & Contents
The liability section of a home policy is the part nobody buys deliberately
Most people buy home insurance for the house. The section that could matter most protects you from what you owe somebody else.
Travel
Working abroad puts you outside a leisure travel policy
A trip taken for work is a different risk from a holiday, and most travel wordings say so in a single short definition.
Travel
Call the assistance line before the hospital calls anyone
The emergency number on a travel policy is not a helpline. It is the office that authorises treatment, guarantees payment and moves…
Life & Income
A policy written in trust pays a person, not an estate
A life policy left outside a trust usually pays into the estate, where it waits for probate and can be counted for tax.
Life & Income
Decreasing term cover follows a debt, not a family
The sum assured falls year by year to track a repayment mortgage. That makes it cheaper and makes it the wrong shape for anything…
Life & Income
Own occupation, suited occupation, any occupation: three different policies
The incapacity definition decides whether a claim succeeds. Two policies with identical benefits can behave completely differently…
Life & Income
Joint life first death leaves the survivor with no cover
One policy covering two people looks efficient. It pays once, ends immediately, and leaves the survivor to buy cover at an older…
Life & Income
Income protection is offset against everything else that pays
The monthly benefit is capped against your earnings, and other income while you are ill is usually deducted from it.
Making a Claim
Two policies on one loss share the bill and do not double it
Dual cover is far more common than people realise. Insurance pays for a loss once, and the insurers settle the split between…
Making a Claim
Insurers share claims data, and the record travels with you
Quotations are checked against industry databases before anyone reads your answers. The record includes incidents you never claimed…
Making a Claim
Why an insurer investigates a claim it fully expects to pay
Validation is routine rather than suspicious. Knowing what triggers a closer look makes the process far less alarming.
Making a Claim
Never admit liability is a condition, not a matter of manners
Saying sorry at the scene feels decent and human. Your policy treats an admission as something that binds the insurer defending you.
Making a Claim
Cancelled, voided and avoided are three different endings
How a policy ends decides what you must declare for years afterwards. The three words are used loosely and mean very different…
Making a Claim
What happens to your cover if the insurer itself fails
Insurer failure is rare and heavily guarded against. It is not impossible, and what protects you differs sharply by country and by…