When you receive compensation from your insurer, you may find yourself facing a wall if your home insurance aims to cover your losses in the event of a disaster.
pure and simple of your request. In what situations could your insurer decline its liability? How can you encourage your insurance to increase the amount of your compensation? What are the remedies against a refusal of compensation? How can you challenge an insurance decision without making the situation worse? We explain everything to you in the following paragraphs.
Why is my insurance rejecting my claim?
Common reasons for insurance company refusals
When you purchase homeowners insurance, you expect any compensation to go smoothly in the event of water damage, fire, storms, natural disasters, theft, flooding, and more. However, it may happen that when requesting compensation after a loss, you find yourself with a response that does not meet your expectations from your insurer.
Understand: you are unfortunately faced with a company that has to take money out of its coffers for you. Their main goal will therefore be to reduce the amounts to be paid as much as possible. This situation may worry or frustrate you, but it is essential to know that you have rights as a consumer and the tools to react appropriately.
Different circumstances can lead your insurer to refuse to compensate you:
- gray areas in the terms of your insurance contract which allows a different reading of it and for you,
- the evidence deemed “too light” calling into question your claim declaration.
- elements considered not covered by your general conditions, to reduce your future compensation.
Refusal of my request for compensation: how can I react effectively?
Your first instinct should be not to sign any documents! You have every right to do so. Don’t worry, this doesn’t mean you won’t receive any compensation or that negotiations will be stopped permanently. By taking this step, you are simply indicating to your insurance company that you wish to continue discussions.
It is essential to understand that you have rights as an insured and that you are not obliged to accept an insufficient compensation offer, or even a refusal of compensation, without being heard.
If you are faced with an inappropriate decision from your insurer or a compensation offer that does not reflect the reality of the damage you have suffered, it is crucial to act firmly. Don’t be afraid to express your disagreement with your insurance. You are neither the first nor the last to find yourself in a conflict situation with your insurer.
In rare cases, by challenging your insurance company’s adjuster alone, it is possible to obtain action from them. However, in most situations, seeking external help will be essential.
Action against your insurance company
Counter-expertise: the tool for contesting an insurance decision
If your attempts at an amicable resolution with your insurer do not bear fruit, there is a weapon used by policyholders in Belgium: second opinion. It is the legal tool provided for the defense of disaster victims.
In Belgium, insurance contracts assist victims through a private expert, known as a counter-expert or even an insured’s expert. You have the possibility of calling on a second opinion to help you resolve the dispute between you and your insurance company. This legal recourse will allow you to:
- analyze the general terms of your multi-risk home contract
- explore the “consumer rights” aspect which you could also benefit from
- assess in detail the damage you have suffered,
- establish a solid file,
- negotiate again, in confrontation with your insurance expert, maximize compensation,
- follow the process until your compensation is paid to you.
The counter-expert: the ally of the victim
Rebelling against your insurance company has become more accessible to everyone since the arrival of second opinions. Contesting an insurance decision is now child’s play! In the event of a disaster affecting your home, requesting a counter-expert can prove extremely beneficial. This professional acts as a neutral expert to assess the damage suffered and objectively assess the situation. This private expert has one mission: to obtain fair and equitable compensation for you.
By being accompanied by a counter-expert, you benefit from:
- its impartial expertise
- its professional damage assessment
- its negotiating strength
- his experience in defending disaster victims
- reduction of the compensation period
- his in-depth knowledge of the insurance sector
Conflict with your insurer: who bears the costs of the counter-expert?
When you find yourself at odds with your insurance company, what will you ultimately have to pay? If you contest the decision of your insurer, for example when the company considers that you are responsible for the loss or that the amount of compensation you are claiming is too high, you have the possibility of being represented by a second expert. However, what is the price to pay for contesting an insurance decision? Nothing or almost nothing: we’ll explain.
Legal protection: free contestation of an insurance decision
Legal protection in home insurance represents a crucial resource for all policyholders. It represents the tool for contesting an insurance decision. It offers a robust and effective defense in the event of litigation or conflict, allowing you to preserve your rights and safeguard your interests.
Legal protection in home insurance is an option that you can add to your home insurance contract. It provides you with financial and legal support. Whether the dispute concerns your insurance company or any other party connected to your home, this protection allows you to assert your rights without having to incur exorbitant legal costs. Unfortunately, many Belgian policyholders are unaware of the existence of this option, which they pay for every year in their contracts.
When you take out home insurance including legal protection, you have access to a second opinion and therefore to a second expert who is available to advise you and help you manage disputes with your insurer.
In short, legal protection in home insurance constitutes a real asset for owners and tenants. When considering homeowners insurance, seriously consider adding legal protection to ensure your peace of mind and safeguard your rights. This means that challenging an insurance decision can be approached without anxiety. Don’t be afraid to voice your disagreement with your insurer: make your voice heard.
The question now is who pays the costs of a counter-expert: it, therefore, depends on whether or not you have subscribed to legal protection because in most cases you will not have to pay anything.
Without legal protection
Even if you have not subscribed to legal protection, you have every right to appoint a counter-expert, the one of your choice. However, note that the fees of the counter-expert will be partially covered (the precise rate will depend on your general conditions).
To simplify: second opinion without legal protection = part of the costs payable by your insurance company + a contribution to be paid on your part.
With legal protection
If you benefit from legal protection, you can therefore request a second opinion free of charge. The counter-expert you have appointed will take charge of the dispute with your insurance company and will defend your interests to obtain a favorable outcome for your claim.