Polish Insurer Refused Your Claim? Here's How to Fight Back

This guide is general legal information, not legal advice. How the rules apply depends on your individual circumstances, and the matter should be assessed by a qualified Polish lawyer. Twoja Sprawa helps you organise the documents for that assessment.

You reported the claim, waited 30–60 days, and now you've received a message: "Refused. We do not cover this claim." Or worse — the insurer is offering an amount that is clearly below your actual losses. What now? Is that the end of the road, or can you still fight for compensation? You have several options, from an internal appeal to a full court claim. Below we explain the most common reasons Polish insurers refuse claims, how the appeal procedure works, what the Financial Ombudsman (Rzecznik Finansowy) does, and when it's worth going to court.

Common reasons for refusal — are they actually valid?

Insurers in Poland tend to refuse claims for a handful of recurring reasons. Here are the most common:

1. Contributory fault on your part — the insurer claims you also share the blame for the accident.

For example: "Someone hit you from behind, but your brakes were faulty — your share of fault is 20%, so we're reducing the payout by 20%." That reasoning is legally valid — if you genuinely contributed to the accident, your compensation can be reduced proportionally. The real question is whether the insurer's assessment is actually correct.

2. Insufficient evidence — the insurer says the file doesn't contain enough documentation.

Example: "You have no police report, no witnesses, and no photos — we cannot confirm the accident happened the way you describe."

⚠️ This is often a weak justification. If you reported the claim on time and the insurer has had its statutory 30 days, it has had time to gather evidence. If it claims evidence is missing, that can sometimes be a pretext for delay.

3. Doubts about whether the incident happened as described — the insurer suggests the accident either didn't happen at all, or happened differently from your account.

Example: "Our vehicle inspection shows the damage could not have resulted from the collision you describe — it looks like it came from a completely different event."

This can be a legitimate objection if it's backed by an independent expert (rzeczoznawca, a vehicle-damage assessor) report.

4. Exclusion from policy cover — the insurer argues the incident simply isn't covered under the policy.

Example: "You had a collision, but the at-fault driver's third-party liability (OC — the compulsory Polish motor liability policy) excludes accidents at night" (if the collision happened after dark).

This may be a valid exclusion — or it may be a misreading of the policy wording by the insurer.

5. Insurer-to-insurer dispute over liability (rarer, but it happens)

The insurer claims that, in fact, you are the one responsible, and therefore it should be your own insurer paying out — not the at-fault driver's OC insurer.

The appeal procedure — how to fight back

If you receive a refusal, don't give up. You have several layers of defence available.

Level 1: Internal appeal (Article 819 of the Polish Civil Code — Kodeks cywilny, "KC")

After receiving the refusal letter, you typically have 14–30 days (depending on the policy terms) to submit an internal appeal. This is a formal letter to the insurer in which you:

• challenge the stated grounds for refusal,
• provide any additional evidence you didn't submit earlier,
• explain why you believe the claim is valid.

Sample appeal letter:

Dear Sir or Madam,

In response to your letter dated [DATE] refusing my claim, I hereby submit this appeal.

I disagree with the grounds for refusal for the following reasons:

1. You state that there is insufficient evidence. However, the police report from case no. [number] clearly identifies the party at fault. A copy is enclosed.

2. My contributory fault was 0% — I was correctly parked and waiting at a pedestrian crossing. The other driver lost control of their vehicle and struck mine.

3. The enclosed medical documentation (referral letter) confirms the injuries sustained in the accident.

I request that you reconsider the claim and pay compensation in full: [amount].

Yours faithfully, [Your details]

Send the appeal by registered post or by email, if the insurer accepts correspondence that way.

The insurer then has another 30 days to review the appeal and issue a final decision.

Level 2: The Financial Ombudsman (Rzecznik Finansowy) — free mediation

If the internal appeal doesn't work, you can take the matter to Poland's Financial Ombudsman. This route is:

• free — there is no fee,
• independent — the Ombudsman is not affiliated with the insurer,
• mediation-based — the Ombudsman seeks a compromise rather than issuing a binding ruling.

The process usually takes 30–60 days. The Ombudsman sends a recommendation to the insurer. It isn't a court judgment, but it carries considerable moral and practical weight — most insurers follow the recommendation, wary of the reputational and regulatory consequences with Poland's consumer protection authority (UOKiK).

How to file a complaint with the Ombudsman:

The form and full details are on rf.gov.pl. You'll need to provide:

• a letter stating the grounds for your complaint,
• copies of your correspondence with the insurer,
• documents supporting your claim.

⚠️ Condition: before you can complain to the Financial Ombudsman, you must first exhaust the insurer's internal appeal procedure — appeal first, then the Ombudsman.

Court proceedings — the last resort

If the Ombudsman doesn't resolve things either, or the size of your claim justifies the cost of litigation, you can sue the insurer.

When it's worth suing:

• The claim is worth at least PLN 3,000–5,000 (below that, court costs can exceed the value of the dispute itself),
• You have solid evidence (police report, vehicle damage assessment, medical documentation),
• The insurer maintains its refusal even after an Ombudsman recommendation in your favour.

What are your chances of winning:

That depends on: - The actual facts of the case (whether the accident happened as described and who was at fault), - Whether you have documentary evidence of the loss, - Whether the insurer has any genuinely valid grounds for refusing.

If the case is clear-cut (police report, no contributory fault, damages well documented), the chances are good. Polish courts frequently rule in favour of claimants in insurance disputes where the evidence is solid.

Lawyer's fees:

If you sue an insurer in Poland, you should have representation — an adwokat or radca prawny (both are Polish qualified lawyers; the distinction is a historical one and both can represent you in court). Fees can be structured as:

• a percentage (typically 10–20% of the amount recovered),
• a fixed fee (e.g. PLN 1,000–3,000 for the whole case),
• an hourly rate (for longer, more complex cases).

Ask a few lawyers for quotes — terms vary considerably.

FAQ — frequently asked questions

How long do I have to appeal an insurer's refusal in Poland? Usually 14–30 days from receiving the refusal letter (it depends on the policy terms — check your documentation). Don't leave it until the last day.

Can the Financial Ombudsman force the insurer to pay? Not directly — the Ombudsman issues a recommendation, and the insurer is expected to follow it (with UOKiK oversight in the background), but the recommendation isn't legally binding like a court judgment. If the insurer ignores it, you'll need to go to court.

Can I go straight to court without involving the Ombudsman first? Yes, there's no legal requirement to contact the Ombudsman before suing. In practice, though, it's worth doing — it's free, and it sometimes resolves the matter.

How long does a court case against an insurer take in Poland? Typically 6–12 months for the first hearing, sometimes longer. Judgment is handed down after the hearing or, in some cases, on the basis of the written case file.

What if I lose the case? You can appeal to a higher court (sąd apelacyjny), but that comes with additional costs. Get advice from a lawyer on your realistic chances before deciding whether to go to court in the first place.

Can I claim for the insurer's delay in paying out? Yes — if the insurer missed the statutory 30-day deadline without a valid reason, you can claim statutory interest for late payment (Article 481 of the Polish Civil Code — currently around 8% per year).