Help!..home insurance say claim invalid

Mark_J_4

Dear all,

please help if possible. At the weekend we awoke to find water pouring through our bathroom ceiling and down through our dining room ceiling. It appears that a weeks worth of snow and ice on a flat portion of our roof had built up and with all the gutters frozen solid had instead flowed over the roof flashing and through the roof tiles into the loft space, then down through our ceilings.
When i called the insurance company 'Endsleigh' under Royal sun alliance umbrella, they said that our claim is not covered by either storm or flood clauses and therefore we have no claim. :mad: When i countered that it must come under some form of insured damage they got a so called senior advisor to brush me off also.

What are our options? If water coming through your ceilings from inclement weather conditions is not insurable, what chance do most people have?
They said 'storm' only relates to xxxkph winds so not applicable.

Anybody have any advice? I have contacted the insurance ombudsman but all they do is wait 8 weeks to see if Endsleigh bother to respond to our complaint.
Does anyone know for sure if something like this should be covered?

Many thanks
Mark

lisyloo

I don't really understand the description but it sound like two problems

1) lack of maintenance and negligence in leaving the buildup.
2) The gutter design sounds poor. Overflow should go somewhere safe not into the house.

You won't get cover for problems caused by either poor workmanship or negligence in not clearing the buildup.

Mark_J_4

Not really applicable on both counts,

1) the portion of flat roof is in-accessible and very high and without proper full house height ladders had no way of noticing the ice/snow build up.

2) the gutters and downpipes had all frozen solid in last weeks big freeze.

We live semi rural and on high ground so snow and ice did not melt for 6 days ! It was quite a freak set of circumstances that caused it.

soolin

Mark_J wrote: »

Not really applicable on both counts,

1) the portion of flat roof is in-accessible and very high and without proper full house height ladders had no way of noticing the ice/snow build up.

.

Not knowing about something is no defence though. I can't see my pitched roof clearly on the main house as I live on a hill and have a very tall house, yet I am still responsible for maintaining it.

A flat roof can be problematic, part of my extension has a flat roof and we have it maintained by an outside company that pitch and bituman (or something like that) it every three or four years. It has the same problem as yours in that the guttering above it often overflows or leaks and pours onto the flat roof that causing a lot more wear and tear than should be expected.

lisyloo

had no way of noticing the ice/snow build up.

This doesn't mean that your insurer is liable.
You are still reposnsible for maintenance however difficult (and you must have known it wasn't easy when you bought the house).

But if you feel agreieved the the advice would be to make a formal complaint.
Have you done it formally via the official complaints procedure.
Personally I would send a letter recorded delivery.

Usually there is a set time in which they respond, but whether they don't responsd or whether you reach deadlock it then puts you into the potential posistion to go to the ombudsman.

You might have made a complaint over the phone but it's important to follow the official procedure to get it to the correct department.
Sometimes there is a different dept for handling complaints and sometimes getting them involved can dramtically change events.

However, regardless of how unfair you feel it is, if your policy does not extend to the set of cirucmstances then they won't be obliged to pay out.
You would have had a opportunity to read the extent of the cover when you started the policy and indeed had a cooling off period if you weren't satisfied.
In general they never cover anything to do with wear & tear, mechnical breakdown or negligence. They only cover specified perils like fire, flood, theft etc.
For on-going maintenance you simply need to budget for it.

cogito

Storm damage obviously doesn't apply here and neither does escape of water which relates to escapes from piping and tanks etc. but if you have accidental damage cover, the loss should fall under that part of the policy.

Many policies do however have a condition which requires that flat roofs are inspected periodically and if there is such a clause and you haven't complied with it, the claim would be ruled out anyway.

Mark_J_4

Thanks for responses guys. Its our first winter in this house so any problems that arose were going to be new to us.
I was just amazed that water ingress causing damage to internal elements of the house is not covered unless a specific like flood or storm.

Airwolf1

Water ingress is covered, but it depends on how it has got into the property. However, if the gutter has frozen, I would assume there can't be a decent run on it to allow the water to take it's course down the fallpipe.
Flat roofs require routine maintenance from time to time and should be inspected (especially before winter).

FlameCloud

cogito wrote: »

Storm damage obviously doesn't apply here and neither does escape of water which relates to escapes from piping and tanks etc. but if you have accidental damage cover, the loss should fall under that part of the policy.

Many policies do however have a condition which requires that flat roofs are inspected periodically and if there is such a clause and you haven't complied with it, the claim would be ruled out anyway.

I am suprised nobody in here that knows about insurance has mentioned this, but the claim shouldn't be paid out under either EoW, Storm or AD- it should be under flood.

The case Rohan vs Cunningham (1999) is very clear on this (in fact, it is almost identical circumstances). The building in question had a flat parapet roof, drained by a single gully. Whilst the property was unoccupied for a few weeks, substantial rainwater ingress occurred, due to the blockage of the gully with leaves. This caused a build up of water on the roof, which ran over the upstands and into the building itself.

The insurer basically tried to kick the claim out for the same reasons as it gave you, not storm and not an EoW. However, the court found with the insured, as a flood (in insurance terms) is a large body of water entering a premises, and not on anything else. The insurers tried to appeal citing the earlier case of Young Vs Royal SunAlliance, but the appeals court sided against them as they wanted to extend the definition of what a flood is.

Accordingly, the insurers were compelled to pay the claim.

I would mention this to them- the law (and FOS) are quite clear on this and the adjuster should really have known this.

Insco

Mark J

It does depend on the policy wording you have, as in any case, but this should be covered as flood damage.

In Rohan Investments Ltd v Cunningham, the court held that a flood could originate from an accumulation of water that was not large, in absolute terms. Whether a particular accumulation of water amounted to a ‘flood’ would depend, at least in part, on the size of the property affected.

[FONT=Verdana, Arial, Helvetica, sans-serif]One of the judges – Lord Justice Auld – went further and indicated that a flood could arise from the slow and steady build-up of water and that it was not even necessary for the ingress of water to arise from a natural phenomenon. In his opinion, ‘flooding may or may not result from such weather extremes [as storms and tempests]’. He went on to say that ‘it is the water that enters and damages the property that is important, not the area or depth of flooding outside that counts’. [/FONT]

RSA Customer Servies are usually very good and fingers crossed you will receive a prompt response to your complaint from them and your claim accepted. Keep us all posted.

FlameCloud

My life, we agree on something!