Insurance Claim Denied in Finland? What to Do Next
An insurance claim denied in Finland is not the end of the matter. Many denials rest on how the insurer has read its own policy wording or the evidence it had in front of it. Both of those can be challenged. The claims decision is usually written in Finnish and refers to clause numbers, which makes it look more final than it is.
Start by finding out exactly why the claim was denied. Then you can ask the insurer to reconsider, complain to FINE or take the case to court. This applies to voluntary insurance such as home insurance, comprehensive car insurance (kasko), travel insurance, accident insurance and health insurance.
Why insurance claims are denied in Finland
Insurers usually deny a claim because they say an exclusion applies, the damage has a different cause, a safeguard was breached, you were grossly negligent or there is not enough evidence. Knowing which argument your insurer has used tells you where the dispute lies.
An exclusion applies. Every policy has exclusions (rajoitusehdot), such as wear and tear, gradual damage or construction faults. The question is whether the exclusion fits what happened. An unclear exclusion is generally read against the insurer that wrote it.
The cause of the damage is disputed. Home and car policies usually pay for sudden and unforeseen damage. Insurers often argue that the damage developed gradually or existed before the incident.
A safeguard was breached. Policies contain safeguards (suojeluohjeet), which are instructions on locking, storing and maintaining property. A breach only matters if it is connected to the damage. It usually leads to a reduced payment rather than a full denial, and the reduction is typically 20 to 33 per cent. In our experience insurers rely on safeguards too readily and cut too much.
Gross negligence or intent. If you caused the damage, ordinary carelessness does not usually bar compensation. As a rule, the insurer has to show that your conduct amounted to gross negligence or intent before it can reduce or refuse the claim on that ground.
Not enough evidence. Many decisions are made on incomplete information. The insurer did not ask for the document that would have settled the matter and decided on what it had.
What to do in the first weeks after a denial
Start by finding out exactly why the claim was denied and what the decision was based on.
- Read the reasoning, not just the outcome. Find the clause or argument the insurer relies on and check it against the policy wording and the product description you received when you bought the insurance.
- Ask for the material behind the decision. You can ask the insurer for the reports, photographs, statements and expert opinions it used. A loss adjuster’s report can show that a key question was never investigated.
- Collect your own evidence. Receipts, photographs, repair invoices, messages and witness details are easiest to gather while the damage is fresh.
- Keep the damaged property if you can. Do not throw away a burst pipe, a broken part or damaged goods before the dispute is settled.
- Check whether you were told about the exclusion. If the seller did not point out an essential exclusion before you bought the policy, the insurer may not be able to rely on it.
The most common mistake we see is answering a question from the insurer without understanding what it is asking. An answer given to the wrong question can be very hard to correct later, because the insurer will rely on it. Before you send any reply, make sure it answers exactly the question the insurer asked.
Who has to prove what
You have to show that an insured event happened and caused the loss. After that, if the insurer relies on an exclusion, a safeguard breach or gross negligence, the burden of proof is as a rule on the insurer.
Denials often reverse the burden of proof and ask you to disprove the insurer’s theory. You do not have to. In accident insurance, for example, you have to show that the accident happened and that the injury is connected to it. Once you have shown that, it is for the insurer to show why it should not pay.
Your options if you disagree
A denial can be challenged in three main ways. They are alternatives rather than a fixed order.
Reconsideration by the insurer. You can ask the insurer to look at the decision again, with new evidence and a reasoned argument. This costs nothing and is often the quickest route.
A complaint to FINE. The Finnish Financial Ombudsman Bureau (FINE) and its Insurance Complaints Board (Vakuutuslautakunta) give recommendations on insurance disputes. The service is free for consumers. Insurers usually follow its recommendations.
Court. You can take the insurer to the district court. For voluntary insurance, the claim must be brought within three years of the date you received written notice of the decision and of this time limit.
About half of the disputes we handle are resolved by a request for reconsideration alone, before the case goes any further.
Does a denied claim affect your insurance?
A denied claim does not normally cut your no claims bonus. In car insurance the bonus usually falls only when the insurer pays out under the cover the bonus is linked to, so a claim that is refused does not count against it.
Disputing a decision does not put your policy at risk either. Asking for reconsideration or complaining to FINE is a normal part of the claims process, and insurers do not cancel a policy simply because you made a claim. An insurer can cancel only on specific grounds, for example where incorrect information was given when the policy was taken out, and in some types of insurance the law does not allow cancellation because of a claim at all.
Denied claims by type of insurance
The arguments insurers use differ between types of insurance. These pages look at the most common disputes in more detail.
- 01Car insurance claim deniedCovers both comprehensive car insurance (kasko) and compulsory motor liability insurance (liikennevakuutus). Collisions, theft, animal collisions, fuel errors, and arguments about the value of a written-off car.
- 02Water damage claim deniedCovers leaking pipes, washing machine failures and roof leaks. This is Finland’s most common home insurance claim and its most frequently disputed one.
- 03Fire damage claim deniedCovers house fires, sauna fires, electrical fires, and claims cut because the insurer alleges negligence.
- 04Vandalism claim deniedCovers deliberate damage to your car, home or property by someone else.
Getting help with a denied claim in English
We are an insurance law firm in Finland, and denied claims are what we do. You can send us the claims decision, the policy schedule and the policy wording in Finnish, because we read them for you. Our free assessment comes back within 24 hours. If you prefer, we also deal with the insurer in English.
If your claim is worth pursuing, we will tell you how and what it costs. If it is not, we will tell you that too, so you do not spend time on a dispute that cannot be won.