home insurance problems

judy_1

in february this year our home insurance was up for renewal i was in our bank sorting out some other issues when i was asked when our insurance was up for renewal i told them it was this now they asked if they could quote, i said that i was happy with the insurance that we has as it was very comprehensive, i was told that there insurance was also comprehensive but would probably be cheaper, i told the lady in the bank that i had only just come out of hospital after having a stroke she issisted on wanting to quote for our insurance which i eventually agreed to she asked me various questions which i answered when she asked me if we had any claims with in the last 5 year i replied no on the policy i also had listed items of jewlery added
however about 2 weeks ago i lost a bracelet that my husband bought me for our 20 wedding aniversary, i reported the loss to the police and got a report i also contacted the retailer to see if they had any information on my bracelet, which they did becaue the bracelet was over £1000,00 they had logged against my husbands name and sent me a full discription of the bracelet along with a copy of the reciept
i put in a claim to our insurance company about the loss on the all risks side of the policy.
a lady came to my house and said that she wanted to ask me some questions she was sent by the insurance company one of the questions that she asked me was why i had not disclosed a claim for a bust pipe in 2003, my aswer to this was that i had forgotten about it, since my stroke which left me with the right front part of my brain damaged, my memory has been very poor. however the lady from the insurance company became quite bullish and i was getting distreessed so i aksed her to leave someone please help what do i do now i believe that the none disclosure a mistake but am now extremely worried

Quentin

You were asked about any claims in the last 5 years.

You say your burst pipe claim was made in 2003 - so you didn't need to declare it in Febtuary 2009!

judy_1

i was told by the person from the bank that the claim was in september 03 and that as it was still within the 6 years that i should have declared it the simple truth i had forgotten about it

dogbot

Hello,

First of all, sorry to hear you have had someone who have been unpleasant, least of all in your home. No one should expect that and I would advised highlighting the issue to the insurer in question.

Because of the imbalance of information, and the reliance on true information, of an insurance transaction, there is a positive duty of disclosure on the proposer to declare all material facts. Previous claims are material. The duty of disclosure is part of the duty of good faith, a principle of law related to insurance.

There are innocent and fraudulent breaches. In your case I feel it is indisputable that it is an innocent breach. To ensure the insurer recognises that it is innocent you may need to provide a letter from your doctor to confirm the medical issues you describe above.

Unfortunate a breach remains a breach. The insurer has the following options:
- Avoid the policy as a whole
- Ignore the breach and allow the policy to stand

In the latter case I would expect an increase in premium to be due. To explain, “Avoiding” the policy will mean it never existed. If the breach is innocent the premium will be returned and no damages can be claimed by the injured party.

Now, the FSA, in ICOBS rule 8.1.1, require insurers to

"not unreasonably reject a claim (including termination or avoiding a policy)."

They further define this as:

Non disclosure, where the policyholder could no reasonably be expected to have disclosed the material fact; or
Non negligent misrepresentation of a material fact

It is understandably that, given the medical issues you describe above, you could forget about the claim when the quote was made. Unfortunately, you would have received your policy documents with a schedule. You should have read though this to ensure the information was correct and returned it when you realised the information about the claim was missing (or so could the insurer argue).

In this case, given your circumstances I would suggest collecting and presenting the evidence of your medical issues to the insurer, in writing, and asking them to consider ignoring the breach and allowing you to pay the additional premium due.

Regardless of what certain people on these forums might thing or say, people who work in insurance companies (and so the companies themselves) are not corrupt or evil or horrible, they are human too.

Even if we were being mercenary, we could conclude that the resultant adverse publicity of a complaint such as this would do more damage than good, particularly as the brand here is one of a bank!

If at first you don't succeed, and the policy is avoided, I would take this to the Financial Services Ombudsman on appeal.

Good luck.

Quentin

judy_1 wrote:

i was told by the person from the bank that the claim was in september 03 and that as it was still within the 6 years that i should have declared it the simple truth i had forgotten about it

You said you were originally asked when taking out the policy:

she asked me if we had any claims with in the last 5 year i replied no on the policy

So they cannot now somehow want to include one from 2003.

Check the papers you have and see what it says about your claim history in the statement of insurance/proposal form. In particular check on over how many years you are asked to declare losses.

dogbot

judy_1 wrote: »

i was told by the person from the bank that the claim was in september 03 and that as it was still within the 6 years that i should have declared it the simple truth i had forgotten about it

They need to clarify if it was 5 or 6 years that they ask about and you need to confirm exactly when the claim was.

What brand is the insurance under?

mattymoo

I've never come across an insurer asking for 6 years of claims disclosure. The norm is 5 years and some only ask for 3.

judy_1

the woman did the whole policy on a computer in the bank so we do not have any paper work the insurance assessor was extremely bossy and i believe rude to me i find now that i am able to be intimidated easily which nobody would have intimidated me prior to my stroke

dogbot

I agree that 6 years seems weird, I mean't to say that before. You must have some documentation somewhere? They should send you a policy booklet and schedule. If not, then you need to complain.

dunstonh

It seems straight forward in what you should do. Formal complaint should be put in if claim rejected on those grounds. The FOS publish guidelines on non-disclosure and expect the insurance companies to act by those. There are examples of real claims in their publication which show where they have upheld and rejected complaints and yours is more similar to the upheld ones than the rejected ones.

judy_1

i have asked them they tell me that you have to declare all claims within the last 5 years, which it appears i did not, however it looks like they are not going to allow my stroke as mittigating reasons for why i did not declare the loss almost 5 years ago