{"id":3731,"date":"2026-03-04T11:53:48","date_gmt":"2026-03-04T10:53:48","guid":{"rendered":"https:\/\/ubezpieczenie-cudzoziemca.pl\/nieskategoryzowane\/odwolanie-od-decyzji-ubezpieczyciela-krok-po-kroku\/"},"modified":"2026-09-29T20:13:10","modified_gmt":"2026-09-29T18:13:10","slug":"appeal-against-the-insurers-decision-step-by-step","status":"publish","type":"post","link":"https:\/\/ubezpieczenie-cudzoziemca.pl\/en\/poradnik\/poradnik-pacjenta-i-faq\/odwolanie-od-decyzji-ubezpieczyciela-krok-po-kroku\/","title":{"rendered":"Appeal against the insurer's decision: step by step"},"content":{"rendered":"
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When is it worth filing an appeal<\/h2>\n<\/p><\/div>\n
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A denial of benefits or an underpayment after a loss can come as a surprise. Often, however insurer's decision<\/strong> is not the \u201elast word.\u201d You have the right to submit cancellation<\/strong> or complaint, pointing out errors in the assessment of the event, missing evidence or misinterpretation of the T&Cs. In practice, many cases can be clarified already at this stage, without court.<\/p>\n

It is worthwhile to act quickly and factually. A well-prepared argument, based on documents and records of your policies<\/strong>, increases the chance of changing the position. In the article we show you how to prepare step by step insurance claim<\/strong>, what deadlines to keep track of, and when it will be helpful to Financial Ombudsman<\/strong>.<\/p>\n<\/p><\/div>\n

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First, check the basis of the decision<\/h2>\n<\/p><\/div>\n
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Start by carefully reading the letter from the insurer. The decision should include: the indicated circumstances of the case, the reasons and the legal basis and\/or provisions of the T&Cs cited by the insurance company. If the benefit is not due or has been awarded in a different amount, the insurer should inform you of the reasons for the denial or partial payment and indicate the possibility of an appeal or a court route.<\/p>\n

At the same time, take the documents: policy, T&Cs, confirmations of premium payment and loss report. If the topic involves a foreigner's stay, also check that the product was matched to the purpose of the stay and official requirements. Guides on the site can be helpful, such as. insurance for visa and residence card<\/a> or description costs of medical treatment of a foreigner<\/a>.<\/p>\n<\/p><\/div>\n

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\ud83d\udca1 Tip<\/h4>\n

Ask the insurer to specify exactly which points of the T&Cs it applied and why. It will then be easier to write an appeal that \u201ebeats the odds.\u201d.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n

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Insurance claim and deadlines<\/h2>\n<\/p><\/div>\n
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In disputes with insurers, the most common way to start is through the claims path. Insurance claim<\/strong> is to formally raise objections to the way the contract is implemented: denial, underpayment of benefits, recognition of disclaimers, or dragging out proceedings.<\/p>\n

According to common market procedures, the insurer should respond without undue delay, at the latest in 30 days<\/strong> from receipt of the complaint. In particularly complicated cases, it may inform of the delay and provide a response within 60 days<\/strong>. The response is provided on paper or other durable medium, and e-mail usually only upon request of the customer.<\/p>\n

You can submit a complaint in writing, electronically (such as the form on the insurer's website) or orally for the record. Take care to have proof of submission: proof of posting, a dated email or a case number. If you have insurance related to residency formalities in the background, also review document guides, such as. Schengen visa type C<\/a> or D-type national visa<\/a>.<\/p>\n<\/p><\/div>\n

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What should be included in the appeal<\/h3>\n<\/p><\/div>\n
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Good cancellation<\/strong> has a clear structure. At the outset, indicate what decision it relates to (date, damage number, policy number), and then write what you expect: full payment, surcharge, reclassification of the event, adjustment of the estimate, or reanalysis of documents.<\/p>\n

Then describe the facts in bullet points and relate them to the T&Cs. If the insurer has invoked an exclusion, show why in your situation there is no causal connection between the indicated circumstance and the loss. If the amount is understated, compare the calculations and indicate which costs should be recognized.<\/p>\n<\/p><\/div>\n

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Documents and evidence: what to include<\/h2>\n<\/p><\/div>\n
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In a dispute with an insurer, documents count. In the T&Cs you will often find a provision that the validity of the claim and the amount of the benefit are determined on the basis of complete documentation. The better you fill in the gaps, the harder it is to sustain a denial.<\/p>\n<\/p><\/div>\n

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