Money. How to contest an insurer's refusal to pay compensation?

Every year, nearly 18,000 claims are filed regarding “life accident guarantee” contracts, due to a refusal rate of around 80%.

Claims related to clay shrinkage and swelling are closed in one out of two cases, and compensation is rarely commensurate with the damage.

When it comes to contesting an insurer's decision, how do you proceed?

The first step will be to carefully read or reread your insurance contract, in particular the general conditions which must mention the procedure to follow with the claims or customer service.

Please note that you have two years to contest a decision, or even ten years for personal injury claims. Then contact the insurance agent with whom you purchased the policy directly to find an amicable solution.

If the loss has given rise to an expert appraisal, request the expert's report, read it and negotiate with the insurer by sending them the necessary documentation (photos, videos, invoices, etc.).

If you have legal protection insurance, now is the time to activate it: it offers legal advice to resolve the dispute amicably and covers legal costs if necessary.

Otherwise, contact the insurance mediator . Independent of any company, they will examine your case to negotiate with the insurer.

Its opinion is certainly only advisory, but it resolves many cases. In its latest annual report for 2023, the insurance mediation service reported 7,103 disputes resolved out of 30,620 referrals.

In the case of an expert report, you can ask your insurer for a counter-assessment by choosing the specialist yourself or by contacting an association.

Asso Sinistre can help you in this regard.

A third appraisal is always possible if discussions between the first two experts prove unsuccessful. It is then chosen by mutual agreement between you and the insurer.

It can also be chosen by a judge if you have decided to take the matter to court. The competent jurisdiction then depends on the amounts at stake: for a dispute under €10,000, it will generally be the local court.

For amounts over €10,000, the matter will be referred to the courts. The procedure can be lengthy, and it's best to seek legal assistance or contact a consumer association.