How to make a complaint about an insurance decision made about your mental health
If you think you have been discriminated against because of your mental health condition when applying or claiming for insurance, you have the right to complain. We explain how to make a complaint and the different steps involved.
There are several steps you can take if you feel your insurer has discriminated against you because of your mental health:
- Ask the insurance company to explain their decision.
- Make a complaint to the insurance provider.
- Make a complaint to the Financial Ombudsman Service.
- Take legal action.
Making a complaint or taking legal action might not be as complicated as you think, and it could lead to the outcome you want. But it can be stressful. You can ask a friend, member of your family or advocate to support you.
If you think an insurance company has discriminated against you, you can get free expert advice from the Equality Advisory and Support Service.
Ask the Insurance company to explain their decision
Your first step should be to talk to the insurance company and ask them to explain why and how they made their decision, and why you are unhappy with how you have been treated - find out what your legal rights are when applying for insurance with a mental health condition.
You can request the following:
- What information they used to make their decision.
- What specific research or data they have used.
- An explanation of how they came to their decision.
Make a complaint to the insurance provider
If you’re still unhappy with the outcome, the next stage is to ask them about their formal complaints procedure - they are obliged by the Financial Conduct Authority, to respond to a formal complaint within eight weeks.
It is advisable to contact the insurance company by email or letter at this stage and keep copies as evidence. But you can complain verbally if you prefer that. No matter how you complain, make sure you use the word ‘complaint’, and explain why you are unhappy and what outcome you want.
Make a complaint to the Financial Ombudsman Service
If you’re unhappy with how the insurance company responded to your complaint, or if they do not respond within eight weeks, the next stage is to make a complaint with the Financial Ombudsman Service.
The Financial Ombudsman Service is an independent body which aims to settle complaints between consumers and businesses providing financial services. They will represent individuals but not companies.
To make a complaint to the Financial Ombudsman Service, you must have already:
- Made a formal complaint to your insurer, and
- Received an official response, or it has been more than eight weeks since you made a formal complaint.
The Financial Ombudsman Service website has information on how to make a complaint. If they decide your complaint is valid, you may receive compensation from the insurance company.
If however, you are unhappy with the Financial Ombudsman Service decision, you can take your complaint to court.
Take legal action
If you decide to take legal action against the insurance company, you must do this within six months of the incident occurring and seek advice from a solicitor. A solicitor that specialises in both insurance and disability law would be beneficial.
You can use the Law Society website, which helps you, filter solicitors, in your local area by speciality. A solicitor will be able to advise you if you have a chance of winning in court. You will usually have to pay fees if you take legal action. But you might be entitled to get legal aid.
If you aren’t entitled to legal aid, and you can’t afford fees, you might be able to get a solicitor on a ‘no win no fee’ agreement. This means you only pay costs if you win the case.
But be sure to carefully check the agreement with the solicitor, as sometimes you still have to pay costs if you lose. You can search on the internet for no win no fee solicitors in your area.
If your claim against the insurance company succeeds, the insurance company may have to pay you compensation.
- Mental health and insurance cover
- What insurance might I need if I have a mental health condition?
- How to find the right Insurance cover with a mental health condition
- Specialist insurance providers for pre-existing mental health conditions
- What are my rights when applying for insurance with a mental health condition?
- How to make a complaint about an insurance decision made about your mental health
- Advice for insurance professionals working with a client who has a mental health condition