Roof claim declined due to moss

Jocelyn-:-) · 14 January 2018 at 8:47AM

Morning all,

I am looking for some advice re my recent insurance claim.

My ridge tiles had slipped during Storm Eleanor last week and I proceeded with a claim to my insurance.

The surveyor came round and I have now been informed that my "claim has been rejected in full" due to wear and tear because, it said, moss can cause the cement to come lose and moisture etc.

I have a few questions:

1) Since the claim was rejected - is this a claim? Do I declare it on my renewal? Do I lose my NCB? I am under the impression that I didn't materially benefit or had my problems rectify, it is not a claim, and it has been rejected - so not a claim?
2) I claimed under emergency call out (under same policy but different company dealt with it) to putt tarpaulin on the roof, is this a claim (I see it more like recovery service on car insurance...)?
3) If it is treated as a claim (will check with insurance company, but want to get an opinion here in case I need to complain), I am planning to make a complain before going to FOS. I read from an ombudsman website that use this type of cases as an example for disputes. I would need some statistics on how many homes are affected - noting that I live in a hamlet type location, statistics would not come to my favour due to the lack of samples. Is this the data I can obtain or should I just ask the insurer for the statistics and make them investigate - leaving grounds for my future complain to FOS.

Many Thanks,
Jo

paddyandstumpy · 14 January 2018 at 8:52AM

Although you haven’t had a claim you’ve suffered a ‘loss’, therefore yes it’ll need declaring under your home insurance.

Home emergency claims don’t generally need declaring under home insurance.

The insurer will have most likely uploaded this ‘claim’ onto CUE (the shared claims database).

What are you planning on Complaining about and why do you need statistics? That part is unclear.

Jocelyn-:-) · 14 January 2018 at 9:50AM

Thanks for the response.

Would I be declaring this under claims, since there is no loss declaration?

I am looking to complain to FOS is it is not resolved but I would like to push the insurer to recognise that, yes there is moss, but the ridge tiles wouldn't have been displaced if there weren't a storm.

The statistics is to see how many claims were made in my area relating to the same issue (displaced tiles / roof issues) during the same time. My thought is that if there were enough claims put through then it shows that it was the storm affecting the property and as such, mine, together with other claims in the generally same situation should not have been dismissed.

paddyandstumpy · 14 January 2018 at 10:05AM

If the questions asked regarding claims includes ‘losses’ then yes you need to declare it.

Off the top of my head the question asked on the aggregator sites is something like “suffered any claims or losses...”

Good luck with getting any stats, short of door knocking your neighbourhood I can’t see how you’d get that info.

Insurers use a system called Weathernet to see if there were any storm conditions at the time of loss.

huckster · 14 January 2018 at 10:27AM

Suggest you complain to your Insurers about the claim being refused.

They say that moss can loosen cement and not that it did loosen the cement.

Most roofs have moss on them. Yes if the moss was excessive, it might cause a problem, but for Insurers to refuse a claim they need to provide clear evidence to support their decision.

Because it costs Insurers a fee of over £500 if you elevated a compaint to the FOS, it is always worth testing the Insurers stance. If you start a complaint, you might find that Insurers will take another look. Be persistent and see what happens. You have to give your Insurers oportunity to resolve.

Remember you have to declare the claim event, having the claim declined and your roof issue to any new Insurers. This will make future Insurances more difficult and expensive. This is why you should try to get your Insurers to change their decision.

Jocelyn-:-) · 14 January 2018 at 10:45AM

Thanks both,

I am going to call tomorrow and see if they have considered the claim as a claim or a claim never existed because it was not compensated - I think the former is more likely.

I had a quick check online re. renewal cost. Most issuers would be happy to renew with me declaring the £0 claim.

The renewal cost is, however about 15% higher (about £50), so not too awful.

Quentin · 14 January 2018 at 10:53AM

You definitely have a loss to disclose if you get asked about "claims or losses"

If you are advised by an agent it's no need to disclose it then ask for that in writing, but you must still disclose it to any other insurer you approach for quotes which asks about losses

(It is possible that it is considered a claim as your insurer did incur costs prior to rejecting it)

Blibble · 14 January 2018 at 12:28PM

Jocelyn-:-) wrote: »

I am looking to complain to FOS is it is not resolved but I would like to push the insurer to recognise that, yes there is moss, but the ridge tiles wouldn't have been displaced if there weren't a storm.

The insurer has to make a reasonable deduction from the assessor's report as to whether the moss build-up has been a significant contributor to the tiles coming loose.

As there seems to be no dispute that there was at least some level of moss, I would have thought the best outcome you could hope for would be the insurer paying a percentage of the claim.

It doesn't hurt to make the complaint; note that the insurer has up to 40 working days to resolve the complaint once notified before FoS can consider a binding decision.

Roof claim declined due to moss

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