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Insurance Claim Rejection Appeal

A completed appeal of a home-insurance rejection setting out policy terms, causation evidence, complaint escalation and FOS warning.

Jurisdiction: England and Wales - completed fictional worked example

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Important: This sample provides general legal information only and is not legal advice. Check the law, prescribed forms and signing requirements that apply to your exact jurisdiction and circumstances before use.

# INSURANCE CLAIM REJECTION APPEAL

Date: 13 January 2031

Parties: Leah Brooks and Meridian Mutual Insurance plc

## 1. Purpose and parties

Leah Brooks appeals Meridian Mutual's 2 January 2031 rejection of claim MM-44721 under her buildings and contents policy for water damage at 22 Alder Street. A failed washing-machine hose on 19 December damaged the kitchen units, flooring and adjoining wall.

## 2. Facts, scope and terms

The rejection invokes an escape-of-water exclusion for gradual seepage and says Leah failed to maintain the appliance. Leah's plumber found a sudden split in a braided hose, isolated the supply the same day and found no pre-existing damp. The policy schedule covers accidental escape of water and contains no term supplied with the rejection that clearly excludes this event.

## 3. Process and responsibilities

Leah asks Meridian to reconsider causation, identify the exact wording and evidence relied on, appoint an independent loss adjuster, and pay the reasonable emergency drying and reinstatement costs less any valid excess. She requests an explanation of the contents valuation and alternative accommodation decision.

## 4. Evidence, records and safeguards

Enclosed are the policy schedule, rejection, dated photographs, plumber's report, invoices, moisture readings and purchase receipts. Leah will preserve the failed hose and allow a reasonable inspection; Meridian should handle her personal data securely and avoid removing evidence before she can record it.

## 5. Review, escalation and outcome

This letter is a formal complaint under Meridian's complaints procedure and asks for a final response within the applicable FCA DISP period. If the response is unsatisfactory or late, Leah may refer an eligible complaint to the Financial Ombudsman Service within its time limit, without treating this appeal as a promise that FOS will accept jurisdiction.

## 6. Reservations and practical protections

Leah mitigated loss by shutting off water and arranging temporary drying, but does not accept an unsupported allegation of policy breach. The appeal does not prevent a separate claim for consequential loss or prejudice her rights under the Consumer Rights Act where applicable.

## 7. England and Wales law and completion

England and Wales law applies. Email to complaints@meridian.example and post to Meridian Claims, Leeds LS1 4AB are separate permitted service methods on 13 January 2031. Leah signs and keeps proof of sending.

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