{"id":3757,"date":"2026-06-26T10:43:39","date_gmt":"2026-06-26T08:43:39","guid":{"rendered":"https:\/\/insurancevisa.com\/nieskategoryzowane\/jak-zglosic-reklamacje-gdy-polisa-nie-dziala\/"},"modified":"2026-09-30T05:26:02","modified_gmt":"2026-09-30T03:26:02","slug":"how-to-file-a-claim-when-your-policy-isnt-valid","status":"publish","type":"post","link":"https:\/\/insurancevisa.com\/en\/poradnik\/najczestsze-pytania-i-problemy-cudzoziemcow\/jak-zglosic-reklamacje-gdy-polisa-nie-dziala\/","title":{"rendered":"How do I file a claim if my policy isn't valid?"},"content":{"rendered":"<div class=\"wp-block-kadence-rowlayout\">\n<div class=\"wp-block-kadence-advancedtext\">\n<p><strong>Policy Claim<\/strong> This is a formal filing of objections to the insurer\u2019s actions when the policy is not being administered in accordance with the contract or when a claim is denied. If you\u2019re having a problem with your policy, don\u2019t just settle for a phone call. It\u2019s best to gather the necessary documents right away, describe the situation, and file a complaint in a way that provides proof of your submission. In this article, we explain how to file a complaint when your policy isn\u2019t working as it should, what a health insurance complaint should include, what the response deadlines are, and what to do if the insurer continues to deny your claim.<\/p>\n<\/div>\n<nav class=\"wp-block-kadence-infobox has-theme-palette-8-background-color has-background\" aria-label=\"Table of contents\">\n<div class=\"kt-blocks-info-box-link-wrap\">\n<div class=\"kt-infobox-textcontent\">\n<h4 class=\"kt-blocks-info-box-title\">Table of contents<\/h4>\n<ol>\n<li><a href=\"#czym-jest-reklamacja\">What is an insurance claim?<\/a><\/li>\n<li><a href=\"#kiedy-polisa-nie-dziala\">When can a policy be considered invalid?<\/a><\/li>\n<li><a href=\"#jak-zlozyc-reklamacje\">How do I file an effective complaint?<\/a><\/li>\n<li><a href=\"#co-zrobic-po-odmowie\">What should you do if your claim is denied?<\/a><\/li>\n<li><a href=\"#faq\">Frequently asked questions<\/a><\/li>\n<li><a href=\"#podsumowanie\">Summary<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<\/nav>\n<div class=\"wp-block-kadence-advancedheading\">\n<h2 id=\"czym-jest-reklamacja\" class=\"kt-adv-heading\">What is an insurance claim?<\/h2>\n<\/div>\n<div class=\"wp-block-kadence-advancedtext\">\n<p>A health insurance claim is a formal request submitted to the insurer in which the customer states that a service was provided incorrectly or that a decision was erroneous. It may concern a denial of benefits, a misinterpretation of the scope of coverage, problems with activating the policy, or improper handling of a claim.<\/p>\n<p>Market practice shows that a complaint may be filed not only by the policyholder, but often also by the insured or a person entitled under the contract. Complaints are usually filed in writing, electronically, or orally for the record. The complaint must include the complainant\u2019s information, the policy number or claim number, the subject of the complaint, and a justification supported by evidence.<\/p>\n<p>It is also important for foreign nationals to distinguish between a formal issue and an actual lack of coverage. Sometimes the policy is valid, but the benefit is not payable due to an exclusion of liability. It is therefore a good idea to read the General Terms and Conditions of Insurance in advance and check whether the incident falls within the scope of coverage. A guide on <a href=\"https:\/\/insurancevisa.com\/en\/guide\/foreigners-most-frequent-questions-and-problems\/insurance-for-hospital-treatment-of-foreigners-coverage\/\">in the field of hospital treatment<\/a>.<\/p>\n<\/div>\n<div class=\"wp-block-kadence-infobox has-theme-palette-8-background-color has-background\">\n<div class=\"kt-blocks-info-box-link-wrap\">\n<div class=\"kt-infobox-textcontent\">\n<h4 class=\"kt-blocks-info-box-title\">\ud83d\udca1 Tip<\/h4>\n<p class=\"kt-blocks-info-box-text\">Before filing a claim, check the policy number, coverage period, scope of benefits, and exclusions in the General Terms and Conditions. This will help you avoid filing a claim based solely on assumptions.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"wp-block-kadence-advancedheading\">\n<h2 id=\"kiedy-polisa-nie-dziala\" class=\"kt-adv-heading\">When can a policy be considered invalid?<\/h2>\n<\/div>\n<div class=\"wp-block-kadence-advancedtext\">\n<p>A problem with an insurance policy doesn\u2019t always mean the same thing. Sometimes the policy wasn\u2019t issued correctly, sometimes the premium wasn\u2019t posted, and sometimes the insurer determines that the incident isn\u2019t covered. For the customer, however, the result is often the same: no medical assistance, no reimbursement, or a denial of benefits.<\/p>\n<p>The most common situations include the policy not being visibly activated in the system, a refusal to cover medical expenses, discrepancies between the policy offer and the General Terms and Conditions, and the rejection of a claim due to an alleged exclusion. In policies for foreign nationals, a common problem also involves misunderstandings regarding the documents required to file a claim or pre-existing conditions.<\/p>\n<p>Before you file a claim, compare your policy document with the terms and conditions of the contract. Check whether the treatment was emergency or elective, and whether there are any restrictions regarding chronic conditions or events that occurred before coverage began. If you want to better understand the basics of your coverage, see also the article on <a href=\"https:\/\/insurancevisa.com\/en\/guide\/basics-of-health-insurance-in-poland\/student-health-insurance-in-poland-or-needed\/\">basics of health insurance<\/a>.<\/p>\n<h3>The most common signs of a problem<\/h3>\n<\/div>\n<div class=\"wp-block-kadence-iconlist\">\n<ul class=\"kt-svg-icon-list\">\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Denial of reimbursement:<\/strong> The insurer refuses to reimburse the costs despite the submission of receipts.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>No authorization:<\/strong> The medical facility cannot confirm that coverage is active.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Discrepancy in the documents:<\/strong> The policy promises a different scope of coverage than the General Terms and Conditions or the certificate.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>No response:<\/strong> The insurer is not responding to the claim.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Unclear justification:<\/strong> The denial decision does not explain the grounds for the denial in detail.<\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"wp-block-kadence-advancedheading\">\n<h2 id=\"jak-zlozyc-reklamacje\" class=\"kt-adv-heading\">How do I file an effective complaint?<\/h2>\n<\/div>\n<div class=\"wp-block-kadence-advancedtext\">\n<p>If you\u2019re wondering how to file a claim when your policy isn\u2019t covering you, start by gathering evidence. Have your policy number, the date of the incident, the denial letter, receipts, email correspondence, call logs, and medical records ready. The more precisely you describe the case, the harder it will be for the insurer to give a vague response.<\/p>\n<p>It is best to file a complaint in writing or electronically with proof of submission. In your letter, specify the nature of the problem, why you believe the decision is incorrect, which provisions of the contract or General Terms and Conditions you are citing, and what you expect. You may request a reconsideration of the case, payment of benefits, reimbursement of costs, or a written explanation of the grounds for the denial.<\/p>\n<p>Many General Terms and Conditions specify a response period of up to 30 days from receipt of the complaint. In particularly complex cases, this period may be extended to 60 days, but the insurance company should explain the reason for the delay. It\u2019s also a good idea to keep a copy of the complaint and proof of mailing. If you\u2019re considering changing your coverage after the dispute is resolved, read the article about <a href=\"https:\/\/insurancevisa.com\/en\/guide\/foreigners-most-frequent-questions-and-problems\/can-i-change-my-insurance-to-a-different-plan-during-my-stay\/\">changing insurance during your stay<\/a>.<\/p>\n<h3>What a complaint should include<\/h3>\n<\/div>\n<div class=\"wp-block-kadence-iconlist\">\n<ul class=\"kt-svg-icon-list\">\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Customer information:<\/strong> first name, last name, address, phone number, and email address.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Policy number:<\/strong> or, if applicable, the claim or case number.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Problem description:<\/strong> A brief and concise account of the events.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Justification:<\/strong> an explanation of why the decision is incorrect.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Evidence:<\/strong> bills, medical records, correspondence, and screenshots.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Request:<\/strong> What do you expect to happen after your complaint is reviewed?.<\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"wp-block-kadence-infobox has-theme-palette-8-background-color has-background\">\n<div class=\"kt-blocks-info-box-link-wrap\">\n<div class=\"kt-infobox-textcontent\">\n<h4 class=\"kt-blocks-info-box-title\">\ud83d\udca1 Tip<\/h4>\n<p class=\"kt-blocks-info-box-text\">Don't write an emotional letter without providing specific details. The most effective complaint is based on facts, dates, document numbers, and quotes from the General Terms and Conditions or the denial decision.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"wp-block-kadence-advancedheading\">\n<h2 id=\"co-zrobic-po-odmowie\" class=\"kt-adv-heading\">What should you do if your claim is denied?<\/h2>\n<\/div>\n<div class=\"wp-block-kadence-advancedtext\">\n<p>What to Do If a Claim Is Denied? First, read the reasoning behind the decision carefully. Check whether the insurer cites a specific section of the General Terms and Conditions, a lack of documentation, an exclusion of liability, or the fact that the incident is not covered by the policy. If the explanation is incomplete, ask for a more detailed explanation in writing.<\/p>\n<p>If the response to your complaint is still negative, you can proceed to the next steps. In practice, these include filing a request with the Financial Ombudsman, pursuing arbitration, or filing a complaint against the insurer with the appropriate authorities. Depending on the case, it may also be possible to pursue your claims in court. The Polish Financial Supervision Authority oversees the market, and the Financial Ombudsman assists in disputes between customers and financial market entities.<\/p>\n<p>It\u2019s worth remembering that a complaint, an appeal, and a grievance don\u2019t always mean the same thing. A complaint refers to objections regarding a service or a decision. A grievance against an insurer may concern the company\u2019s overall conduct. If you\u2019re planning to take further action following a dispute, you may also find this article useful: <a href=\"https:\/\/insurancevisa.com\/en\/guide\/foreigners-most-frequent-questions-and-problems\/change-of-insurance-during-stay-new-plan\/\">new insurance plan<\/a>.<\/p>\n<h3>A Practical Step-by-Step Guide<\/h3>\n<\/div>\n<div class=\"wp-block-kadence-iconlist\">\n<ul class=\"kt-svg-icon-list\">\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Step 1:<\/strong> Request a full explanation of the grounds for the denial in writing.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Step 2:<\/strong> File a complaint, including supporting evidence and your own position.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Step 3:<\/strong> If you receive a negative response, consider seeking assistance from the Financial Ombudsman.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Step 4:<\/strong> If necessary, seek an out-of-court settlement or take legal action.<\/span><\/li>\n<li class=\"kt-svg-icon-list-item\"><span class=\"kt-svg-icon-list-text\"><strong>Step 5:<\/strong> Keep a record of all correspondence and response deadlines.<\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"wp-block-kadence-advancedheading\">\n<h2 id=\"faq\" class=\"kt-adv-heading\">Frequently asked questions<\/h2>\n<\/div>\n<div class=\"wp-block-kadence-advancedtext\">\n<h3>How do I file a claim if my policy isn't valid?<\/h3>\n<p>It is best to do this in writing or electronically, with proof of submission. In your claim, include your personal information, policy number, a description of the problem, your justification, and supporting evidence. If the matter concerns medical treatment, also attach medical documents and receipts.<\/p>\n<h3>Does a health insurance claim have to be submitted on a special form?<\/h3>\n<p>Not always. Many insurers provide their own form, but you can also draft an effective complaint on your own. The most important thing is that it includes your identifying information, the policy number, the details of your objections, and your request.<\/p>\n<h3>How long does the insurer have to respond?<\/h3>\n<p>As a general rule, a response to a claim should be provided within 30 days of receipt. In more complex cases, this period may be extended to 60 days. However, the insurer should inform you of the reason for the delay.<\/p>\n<h3>Denial of Benefits: What Should I Do If I Disagree with the Decision?<\/h3>\n<p>First, ask for a full explanation and check whether the decision is based on a specific provision in the General Terms and Conditions. Then, file a complaint and include evidence that challenges the insurer\u2019s position. If that doesn\u2019t help, consider filing a complaint with the Financial Ombudsman.<\/p>\n<h3>Where can I file a complaint against an insurer?<\/h3>\n<p>Depending on the nature of the matter, you can file a complaint or request intervention with the Financial Ombudsman, or use the supervisory and alternative dispute resolution tools available in the financial market. It\u2019s also worth checking whether your situation stems from coverage limitations described in the General Terms and Conditions. It can be helpful to compare this with the article on <a href=\"https:\/\/insurancevisa.com\/en\/guide\/foreigners-most-frequent-questions-and-problems\/insurance-options-without-employment-in-poland-for-foreigners\/\">unemployment insurance options<\/a>.<\/p>\n<h3>Do foreigners in Poland have the same rights to file complaints?<\/h3>\n<p>Yes, if they are a party to the contract, the insured, or a beneficiary under the policy, they may file a claim in accordance with the terms of the contract and applicable regulations. It is essential to keep the documents, the policy number, and proof of medical treatment or denial of benefits.<\/p>\n<\/div>\n<div class=\"wp-block-kadence-advancedheading\">\n<h2 id=\"podsumowanie\" class=\"kt-adv-heading\">Summary<\/h2>\n<\/div>\n<div class=\"wp-block-kadence-advancedtext\">\n<p>If you have a problem with your policy, act quickly and methodically. Review the General Terms and Conditions, gather evidence, file a claim, and keep track of response deadlines. In many cases, a well-prepared health insurance claim is enough to have an incorrect decision corrected. However, if your claim is still denied despite your explanations, seek assistance from the Financial Ombudsman or pursue further legal action. If you want to better understand your rights and the scope of your coverage, be sure to review other guides on insurancevisa.com.<\/p>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>A policy complaint is a formal notification of objections to the insurer\u2019s actions when the policy is not being administered in accordance with the contract or when a claim is denied\u2026<\/p>","protected":false},"author":2,"featured_media":3756,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"categories":[43],"tags":[55,61,63,56,54],"class_list":["post-3757","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-najczestsze-pytania-i-problemy-cudzoziemcow","tag-cudzoziemcy-w-polsce","tag-koszty-leczenia-cudzoziemcow","tag-owu","tag-polisa-medyczna","tag-ubezpieczenie-zdrowotne"],"acf":[],"yoast_head":"<!-- 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