Claim denials
The patterns behind denied and delayed claims
Every case story Solvh publishes falls into one of these recurring categories.
Pre-existing condition and pre-existing damage exclusions
One of the most common reasons a claim is refused is that the insurer says the condition or the damage was already there before the policy began. The dispute is rarely about whether something existed. It is about whether the insurer proved it existed, and whether it was actually related to the claim.
Claims denied without a proper investigation or survey
Some claims are refused after a remote review of photographs or documents, with no physical inspection, no site visit, and no contact with the claimant. The denial reads as a finding of fact, but no fact-finding took place.
Medical necessity denials
A treating doctor admits the patient. The insurer's medical team, which has not seen the patient, decides the admission was not necessary. These denials substitute a remote opinion for a clinical one.
Short settlement and unexplained deductions
The claim is not refused outright. It is paid at a fraction of the amount, with deductions the policyholder cannot get explained. Without an itemised breakdown there is no way to tell a valid deduction from an arbitrary one.
Mis-selling and policy changes without consent
What was promised at the point of sale and what appears in the policy document are not always the same. Cover gets reduced at renewal, riders disappear, refund terms turn out different from what was said on the call.
Claim delays and grievance loops
Not every failure is a refusal. Some claims sit unresolved for weeks while acknowledgement emails accumulate and no one takes ownership. Delay is its own harm, and it is escalatable in the same way a denial is.