# Complaint about a rejected home insurance claim _Official complaint procedure, version 1.2. Published and maintained with HandleFirst._ > Demonstration simulation: this assistant has been given access to Kustwal's published procedure contract. General-purpose AI assistants do not universally discover WebMCP endpoints, hidden files or new websites automatically. **This procedure helps you submit a complaint. It does not assess your policy coverage, decide your claim or provide legal advice.** ## Official procedure contract - Issuer: Kustwal Verzekeringen - Environment: Kustwal Verzekeringen · Demonstration Environment - Status: Approved demonstration contract - Version: 1.2 - Effective date: 2026-06-01 - Approved by: Customer Relations, Compliance - Schema: handlefirst.procedure-contract/v1 - Procedure: rejected-home-claim - Jurisdiction: Netherlands (placeholder value) ### Representations - Human readable: /complaints/rejected-home-claim - Machine readable, JSON: /complaints/rejected-home-claim.json - Agent readable, Markdown: /complaints/rejected-home-claim.md ## What this procedure covers A complaint about a rejected home insurance claim, or about the way that claim was handled. ### What this procedure does not decide - whether the policy covers the damage - whether the claim decision was right - who is responsible for the damage - what compensation, if any, is due - what your legal rights are ## Where the requirements come from ### Applicable obligations The formal obligations that apply to complaint handling. They fix what a complaint file has to identify: who is complaining, which decision is questioned, and what is asked of the insurer. ### Approved complaints policy The complaints policy approved by Customer Relations and Compliance. It sets the channel a complaint arrives through, the notice that goes above a prepared complaint, and the rule that Kustwal accepts a complaint even when a document is missing. ### Handling practice What complaints handlers need in order to start work without a follow up question. Reviewed with each version of this contract. Individual complaints are never published and never leave the case system. ## What a complaint has to contain ### Policy reference - Why it is needed: It identifies the policy the complaint is about, so the complaint reaches the right file. - Question: What is your policy reference? - Needed to start: no - Format: A policy reference is two letters, a hyphen and four digits. - Pattern: `^[A-Z]{2}-[0-9]{4}$` ### Claim reference - Why it is needed: It links the complaint to the claim that was decided. - Question: What is the reference of the claim that was rejected? - Needed to start: no - Format: A claim reference is two letters, the year and five digits. - Pattern: `^[A-Z]{2}-[0-9]{4}-[0-9]{5}$` ### Claim type - Why it is needed: It tells the complaints team which kind of claim was decided. - Question: What kind of claim was it? - Needed to start: no ### Current situation - Why it is needed: It states where the claim stands now, so the complaint starts from the right point. - Question: What is the current situation with your claim? - Needed to start: no ### Requested route - Why it is needed: It records that you are making a formal complaint rather than a new claim. - Question: Do you want to make a formal complaint about this decision? - Needed to start: no ### Contact email - Why it is needed: It is the address the complaints team replies to. - Question: What email address should Kustwal reply to? - Needed to start: yes - Format: Please give an email address the complaints team can reply to. - Pattern: `^[^\s@]+@[^\s@]+\.[^\s@]+$` ### Date of the rejection decision - Why it is needed: It fixes which decision the complaint is about. - Question: What date is on the rejection decision? - Needed to start: no - Format: Please give the date as year, month and day. If you are not sure of the exact date, an approximate date is enough. - Pattern: `^[0-9]{4}-[0-9]{2}-[0-9]{2}$` ### What you are dissatisfied with - Why it is needed: It is the substance of the complaint: the part the complaints team has to answer. - Question: What part of the decision or claim handling are you dissatisfied with? - Needed to start: yes - Format: Please describe in your own words what you are dissatisfied with. - Minimum length: 20 - Maximum length: 2000 ### What you would like to happen - Why it is needed: It tells the complaints team what you are asking for. - Question: What would you like Kustwal to do next? - Needed to start: no - Options: Reconsider the claim decision, Explain the decision, Correct something in the claim file, Contact from a complaints handler ## Evidence you can add ### The rejection letter - Why it is needed: It shows exactly what was decided and on what date. - Question: Please upload the decision letter, if you have it. - Accepted formats: PDF, JPG, PNG - Maximum files: 3 ### Earlier correspondence - Why it is needed: It shows what has already been discussed, so nothing is asked of you twice. - Question: Please add earlier letters or emails about this claim, if you have any. - Accepted formats: PDF, JPG, PNG - Maximum files: 5 ### Photographs, invoices or other loss evidence - Why it is needed: It shows what was already sent with the claim, so the complaints team looks at the same material you did. - Question: Please add photographs or invoices you already sent, if that is useful. - Accepted formats: PDF, JPG, PNG - Maximum files: 10 ## If something is missing You can make a complaint even when you cannot supply every document. Your contact email and a description of what you are dissatisfied with are enough to start. If something is missing, the complaints team may come back to you with a question. A missing item never stops you from making a complaint. ## Where a complaint goes ### The Kustwal complaints channel Complaints reach the complaints team at the complaints mailbox. This channel is unchanged. A complaint prepared with this procedure arrives the same way as any other complaint. - Email: complaints@kustwal.example The complaints team confirms receipt of every complaint that reaches this channel. ## What a prepared complaint contains 1. Policy reference 2. Claim reference 3. Date of the decision 4. What the claim was about 5. What I am dissatisfied with 6. Attached evidence 7. What I would like to happen 8. Contact details **Illustrative procedural guidance, not legal advice. Please review this complaint before sending.** ## What a prepared complaint never contains ### Conclusions about policy coverage What the policy covers is decided in the claim, not in the complaint. The complaint says what happened and what you are asking for. - Indicative phrases: `is covered`, `is not covered`, `must be covered`, `should be covered`, `policy covers`, `coverage applies`, `falls under the policy` ### Assessments of liability A complaint does not settle who is responsible for the damage. - Indicative phrases: `is liable`, `are liable`, `liability for`, `at fault`, `your fault`, `responsible for the damage` ### Fraud assessments Nothing in a prepared complaint raises or answers a fraud question. - Indicative phrases: `fraud`, `fraudulent`, `dishonest`, `misrepresentation` ### Claims that the insurer acted unlawfully or in bad faith A complaint describes what happened and what you want looked at again. It does not accuse. - Indicative phrases: `unlawful`, `illegal`, `bad faith`, `acted in breach`, `breach of contract`, `in violation of`, `negligent` ### Invented facts, dates, rights, regulations or case law Everything in the complaint comes from what you supplied. Nothing is filled in for you. - Indicative phrases: `pursuant to article`, `under article`, `case law`, `the court ruled`, `jurisprudence`, `ecli:`, `regulation (eu)`, `directive 20` ### Threats of escalation Asking for the decision to be looked at again is enough. - Indicative phrases: `legal action`, `take you to court`, `court proceedings`, `i will sue`, `my lawyer`, `ombudsman`, `report you to` ### Compensation calculations A complaint does not price the damage. - Indicative phrases: `compensation of`, `damages of`, `total amount due`, `interest at`, `i demand payment`, `pay me the sum` ### Generic legal boilerplate Standard clauses add length and nothing else. - Indicative phrases: `without prejudice`, `reserve all rights`, `all rights reserved`, `formally demand`, `applicable law`, `notwithstanding`, `whereas the` ## Change history - 1.0 · 2025-11-03 · First published version of the complaints procedure for rejected home insurance claims. - 1.1 · 2026-02-16 · Added the plain language purpose to every requirement. Recorded that evidence is useful but never required. - 1.2 · 2026-06-01 · Added the machine readable and agent readable representations. Recorded the rule that a complaint is accepted when a document is missing.