How long can the insurer take?

Complaints handling timescales are set by the insurer's complaints procedure and by the rules that apply to insurers. Ask for a final response in writing so you know where you stand.

What if my appeal is refused?

Ask for a final response letter. Once you have it, you can normally refer the complaint to the Financial Ombudsman Service, which is free to use.

Send-a-Letter.co.uk

Challenge a declined health insurance claim

Has your claim been declined or only partly paid? This letter asks the insurer to reconsider, with your reasons set out.

Your details

Full name Street and number

Postcode Town or city

Who are you writing to?

Name of the company or organisation Street and number

Postcode Town or city

Country

About your letter

Claim number (optional)Shown on the decision letter or in your online account.Date of treatment (optional)Amount claimed (optional)Why should this be covered? For example: the treatment is covered by my policy, or it was pre-authorised, or I have a referral from my doctor.

Preview of your letter

This is exactly what goes on paper.

Full name

Name of the company or organisation

25 July 2026

Re: Appeal against declined claim

Dear Sir or Madam,

My appeal is based on the following

I ask you to reassess the claim and to write to me with a reasoned decision. If you maintain your decision, please treat this letter as a formal complaint, issue a final response, and set out what further steps are open to me.

Yours faithfully,

Full name

Email address We send your confirmation here.Send by recorded deliveryWith proof of posting and proof of delivery.

What to look out for

Check your policy wording first, along with any excess and any limits or exclusions that apply.
Quote the exact wording of your policy that you say covers the treatment.
Attach or offer supporting evidence such as a referral letter, pre-authorisation or treatment plan.
Reply within any deadline stated on the decision letter.
If the insurer issues a final response and you are still unhappy, you can usually take the complaint to the Financial Ombudsman Service free of charge.

FAQ

How long can the insurer take?: Complaints handling timescales are set by the insurer's complaints procedure and by the rules that apply to insurers. Ask for a final response in writing so you know where you stand.
What if my appeal is refused?: Ask for a final response letter. Once you have it, you can normally refer the complaint to the Financial Ombudsman Service, which is free to use.

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