General legal guide - Personal insurance policies

Following a serious injury, it is important that an injured party checks all insurance policies to establish whether they have the benefit of no-fault insurance cover or critical illness cover which provides for a payment in the event of illness/injury. They should also check whether they have payment protection insurance which could cover debt, loan and mortgage payments in the event of serious injury/illness.

The first step is to check all insurance policies or telephone the insurer or broker in the event that policies cannot be found. It is important to do this as soon as possible as claims are often subject to strict time limits set out within the policy document. The insurer will provide a claim form and may require the person making the claim to undergo a medical assessment before a decision is made.

If the claim is refused or a reduced amount is awarded and the person claiming disagrees with the insurance companies' decision, they can make a complaint to the insurance company. If they are still unhappy with the decision, a complaint can be made to the Financial Ombudsman Service. The Financial Ombudsman Service is an independent and impartial service which aims to settle disputes between businesses and their customers.

The Financial Ombudsman will not accept a claim until the complaints procedure has been exhausted. A complaint to the Financial Ombudsman Service must be made within 6 months of the date of the final response from the insurance company. The Ombudsman's final decision is binding on a consumer if he accepts the decision within the timescale set.

Further Information

Financial Ombudsman Service

0845 080 1800
020 7964 0500