Appealing an Insurance Decision – How to Challenge Your Insurer's Ruling
If you disagree with a decision made by your insurance company, you have the right to challenge it. The appeals process moves through several stages, and most disputes are resolved well before reaching court. Legal expenses insurance plays a key role — for example, by covering your lawyer's fees throughout the process.
How Does the Insurance Appeals Process Work?
The process typically unfolds in stages, and most cases are resolved early on without the need for court proceedings.
The first step is submitting a reconsideration request directly to your insurance company. At this stage, it's important to clearly explain why you believe the decision is incorrect and to attach all relevant supporting documents. In many cases, the decision is revised or clarified at this point alone. If the matter is not resolved through reconsideration, it may be escalated within the insurance company — for example, to an internal customer ombudsman. The goal is to reach a resolution without external dispute resolution, and many cases are settled at this stage.
The next step is to bring the matter before the Insurance Complaints Board (Vakuutuslautakunta). The Board issues free, non-binding recommendations on insurance disputes. While its decisions are not legally enforceable, insurance companies follow them in practice in almost all cases.
If the issue remains unresolved, it can be taken to a District Court (käräjäoikeus). This is generally the last resort, as the process is slower, more expensive, and carries greater risk for all parties involved.
Can Legal Expenses Insurance Be Used in an Insurance Dispute?
Legal expenses insurance is a central resource in the appeals process. It can be activated at multiple stages — the matter does not need to reach court. It is sufficient that a lawyer is handling the case and that the dispute could, in principle, be brought before a court. Importantly, legal expenses insurance can also be used when the dispute is with the very insurer that issued the legal expenses policy.
The insurance can cover legal fees and case investigation costs up to the policy limit, leaving the policyholder responsible only for the excess (deductible). Not all situations are covered, however — for example, if arbitration proceedings or a court jurisdiction outside Finland has been agreed upon. That said, costs such as preparing a request for an expert opinion can in most cases be reimbursed through legal expenses insurance, with the client paying only the deductible.
Claims Link can help you choose the right course of action and guide your case forward. We can also apply for legal expenses insurance coverage on your behalf.
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