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Explainer Your rights · 5 min by Krantz & Polak

Your claim has been rejected — what now?

A rejection is not the end of the road. Here is how to establish the reason and decide on your next steps.

A rejected claim feels like a closed door. Yet a rejection is often the beginning of a conversation, not the end of one.

Common reasons for rejection

  • The damage is said not to fall within the cover, or to fall under an exclusion.
  • Discussion about the cause (for example groundwater or overdue maintenance).
  • A suspicion of fraud, or the reproach that information was missing.
  • The claim is said to be time-barred or to have been reported too late.

Step by step

  1. Request the rejection in writing, with reasons. You are entitled to a clear explanation, with reference to the policy conditions.
  2. Set the reason against your policy. Is the interpretation of the conditions correct? Exclusions are sometimes applied more broadly than is justified.
  3. Gather counter-evidence. Photographs, reports, witnesses and an independent assessment can turn the picture around.
  4. Lodge an internal complaint and ask for the decision to be reconsidered.
  5. Weigh up the next steps carefully. A binding Kifid decision can, after an unfavourable outcome, block the route to the courts. So first take advice on whether Kifid or going straight to court is the wiser route in your case.

If fraud is suspected

A suspicion is not yet proof. The insurer bears the burden of proof if it refuses a claim in full on the basis of suspected fraud — a mere suspicion is not enough. Do not allow yourself to be brushed aside; a well-substantiated file and an independent assessment are then all the more important.

Tip — Always respond to a rejection in writing and within the deadline. An independent counter-expert can assess whether the rejection is justified and which route offers the best prospects. Krantz & Polak can also assist you legally in this and — in cooperation with renowned law firms — facilitate taking the matter to court.

When is your own expert a wise choice?

Not for every minor claim — but in these situations your own counter-expert almost always achieves a better and fairer outcome:

  • The damage is substantial (guideline: from around € 5,000).
  • The insurer doubts your account or accuses you of intent, negligence or fraud.
  • The cause or circumstances are unclear — often with fire or water damage.
  • An exclusion or deduction is invoked that you do not understand.
  • There is underinsurance, or discussion about current value and depreciation.
  • There is business interruption loss on top of the damage to property or contents.
  • Your claim has been (partly) rejected.
  • Before you sign — or before the insurer's expert records the damage one-sidedly.

Not sure whether it makes sense in your case? A first check costs nothing.

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