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In New Zealand, if your house insurer has rejected part of your claim, you can make a formal complaint to the insurer and, if it isn't resolved, ask an independent insurance dispute resolution service to review it. You don't have to accept the insurer's decision just because it has been made.

The best route depends on which insurer you use and the reason it has declined part of your claim. Here's how to proceed.

1. Complain to your insurer first

Write to your insurer's complaints team and say that you dispute the decision to decline part of your claim. Ask for a formal review under its internal complaints process.

In your complaint, include:

• Your claim number and the date of the damage.
• The part of the claim that was rejected and the amount involved, if known.
• Why you disagree with the decision.
• Relevant evidence, such as photos, building reports, repair quotes, invoices or an independent assessment.
• What outcome you want, such as payment for the declined repairs or a reassessment by another assessor.

Ask the insurer to explain its decision in writing, including the exact policy wording it relies on, the evidence considered and why it believes that wording applies to your damage.

Keep copies of all correspondence and take note of any complaint deadlines. If repairs are urgent, explain that in writing and ask how you should proceed while the dispute is being reviewed.

2. Get an independent review

New Zealand has free, independent dispute resolution schemes for insurance complaints. You generally need to give your insurer a chance to resolve the complaint first. Which scheme you use depends on your insurer. Complain about your financial services providerWhat can we help with?

Insurance & Financial Services Ombudsman Scheme (IFSO)

Handles complaints about participating insurers and other financial service providers. Its service is free and independent.

• Phone: 0800 888 202
• Website: ifso.nz

Source: Insurance & Financial Services Ombudsman SchemeResolving disputes and claims

Financial Services Complaints Ltd (FSCL)

Investigates eligible complaints, including declined insurance claims, for insurers that belong to its scheme.

• Phone: 0800 347 257
• Website: fscl.org.nz

Source: Make a complaintFAQs

There is also the Financial Dispute Resolution Service (FDRS), which handles complaints about its participating providers. You can call 0508 337 337 or visit fdrs.org.nz. The process » Financial Dispute Resolution ServiceComplain about your financial services provider

How to choose: Ask your insurer which external dispute resolution scheme it belongs to, or check the dispute resolution section of your policy documents. You can also contact FSCL and ask them to direct you to the correct scheme. Complain about your financial services providerSearch financial service providers

The independent scheme can examine your complaint and the insurer's reasons, and try to resolve the dispute. Depending on the scheme and its rules, it may also make a formal decision.

Important: Check the deadline in your insurer's final response or deadlock letter. Referral deadlines can be short, so don't assume you can wait indefinitely. Fair Insurance

3. If your claim relates to a natural disaster

If the rejected part concerns earthquake, flood or other natural-disaster damage, the New Zealand Claims Resolution Service may also be able to help. It offers information about dispute options and access to independent mediation for eligible insurance disputes. Resolving disputes and claims

You can also consider getting an independent building report or repair estimate if the disagreement is about the cause of damage, the extent of repairs required or the cost of reinstatement. Ask the insurer whether it will reconsider its decision based on that evidence.

4. A complaint letter you can use

Writing

Subject: Formal complaint – partial decline of house insurance claim [claim number]

Dear Complaints Team,

I am writing to make a formal complaint about your decision to decline part of my house insurance claim, reference [claim number], relating to damage at my property on [date].

I disagree with the decision to decline [describe the repairs, damage or costs that were rejected].

Please arrange a formal review of this decision. I would like you to:

1. Explain the specific policy wording relied on to decline this part of the claim.
2. Provide the reasons for your decision, including the evidence and assessments considered.
3. Reconsider the declined portion of the claim, taking into account the supporting evidence I have provided.
4. Arrange for an appropriately qualified person who was not previously responsible for the decision to review the matter, if possible.

My reasons for disputing the decision are as follows:

[Briefly explain why you believe the damage or repairs should be covered.]

I would like the declined portion of my claim to be accepted and the reasonable costs covered in accordance with my policy.

Please confirm that you have registered this as a formal complaint and advise me of the next steps and expected timeframe for your review.

If we cannot resolve this complaint, please provide details of your external dispute resolution scheme and explain how I can refer the matter for independent review.

Kind regards,

[Your name]

I can help you work out your next step

Which insurance company are you with, and what reason did they give for rejecting part of the claim?

For example, they might have rejected the cost of some repairs, said the damage was caused by gradual deterioration, disputed the cause of the damage, or applied an exclusion in the policy.

With those two details, I can help you identify the right independent complaints service and suggest how best to challenge the specific decision.