Drains Insurance claim refused by loss adjuster

jowass

I a hoping someone can give me some advice please. We have lived in our house for 2 1/2 years and are insured with L&G, several weeks ago, we discovered sewage coming through a containing wall at 2 separate points and called out dyno-rod. They came and told us that it looked as though we had a collapsed/broken pipe and they would need to carry out a camera survey and that we should claim through our insurers which they could handle on our behalf. We followed their advice and the camera survey confirmed serious problems with the pipes underground. The survey findings were sent to L&G.

L&G contacted us to clarify our claim and the details of the problem etc and they passed the claim over to their loss adjusters, which I understand is standard practise for claims of £1000 or more of value?

The loss adjuster came 2 weeks ago. When he was here he asked me if there had been any problems with the drains in the past, I honestly answered yes - the drains had been blocked by the children throwing baby wipes down the toilet a few months after we had moved here and we had them cleared at our expense, and then last year, the drains had been blocked again by my toddler throwing feminine items down the toilet, which again, we had cleared straight away at our expense.

I have heard today that he has instructed L&G NOT to pay out for the claim, but not giving any reason for it. I contacted him (which I was advised to do) to find out why. At first he tried to tell me that he believed this was a long standing problem, pehaps from even before we had lived here. I replied to him that the sewage coming through the wall and onto the garden, only started a few weeks ago and we called dyno-rod straight away, I would not have allowed my children to play in a garden with contaminated sewage at all - let alone for over 2 years! I also pointed out to him that if this was the case - the surveyor who carried out the mortgage survey and the detailed survey for us would surely have raised this issue (he could not deny this as I had given him a copy of the survey reports on his visit).

He then said that perhaps the problems were not as long standing as that, but that due to the fact that we had had to have our drains cleared on 2 previous occassions, we should have had a camera survey done at those incidences and he was denying our claim on the grounds of our negligence as the problem could have been found and rectified much sooner. I responded that we have NEVER had sewage coming through a wall before and that if we had, we would certainly have addressed that at the time. The reason that we had the drains cleaed in the past was because the children had been flushing baby wipes! We had no reason to suspect there were other problems going on underground because the drains were cleared and as far as we were concerned - everything was working just fine!

The solicitors acting on behalf of dyno-rod (therefore and us), have told me that they will be persuing this further as they do not believe we have acted negligently, our claim is completely justified and we are covered under the terms of our insurance policy.

Is this 'normal' practise by the insurance company/loss adjusters? The longer this goes on, the worse the problem is getting and the containing wall is taking on more water and before long will be in danger of collapse.

Please can anyone offer me some advice?

mattymoo

I feel personally that you have acted reasonably. After all, Dyno-Rod would love to sell you their services and would have quickly suggested a camera survey after the first 2 incidents if they felt it was justified.

As it was, you were relying on their professional guidance. I'm guessing they jetted the drain and the Dyno-rod franchisee felt this was the appropriate course of action in the circumstances.

Did the camera survey indicate what has caused the drain issues? I've seen a few surveys before and the usual suspects are blockage by inappropriate items, tree roots, collapse due to age (pitch fibre pipe sewers especially prone - see http://www.financial-ombudsman.org.uk/publications/technical_notes/pitch-fibre-pipes.html) and crushing of drains by heavy vehicles. The first should not be an issue since you've had the drains jetted twice in just over 2 years. With the heavy vehicles - skip hire lorries are a common cause, during the loading of a heavy skip, the weight is all suspended above the back axle during the lift. Any major building works involving skips?

As for maintenance, here are the search results on the Financial Ombudsman Service website. 24 hits for maintenance so there ought to be something in there to help. http://213.121.208.42/query.html?qt=maintenance&sp-a2=00011c9e-sp00000000&col=fospub

jowass

Hi, thanks for your response.
The first two instances where we had to get the drains cleared, we did not use dyno-rod, I can't remember the name but they definately didnt raise any concerns.
We called dyno-rod in the 3rd instance because we had put in a couple of searches as to what could be causingthe problem) on the internet and most of the search results were coming up with 'collapsed pipes', quite simply - dyno-rod said they deal with that in their yelow page ad, hence why we called them. The drains were not blocked this time.
Apparantly the survey showed that there are several cracks or holes in the pipes (which are clay), one I think did state due to tree roots - although there are no trees! But there has definately not been any heavy or plant machinery in our garden, so the cause to the other holes/cracks I do not know. (At the time however, digging of foundations had just begun for a house that is being built next door to us, but the digging is at least 30 feet away)
In te meantime, I will definately have a look through the info from the FSA you have recommended and see if I can find anything that can help.
Thanks again

mattymoo

Ah - you could have found the cause then. Was there any use of vibrating plant in the ground preparation or foundation work next door? I'm thinking piling rigs, bore hole drilling rigs, i.e. the kind of thing you would have felt in your house while they were in use.

Builders and contractors should carry CAR - contractors all risks cover - that includes non-negligent liability cover for damage to neighbouring properties as a result of piling, drilling, ground dewatering etc.

This is an obscure cover called JCT 21.2.1 from the clause number in the JCT - Joint Contract Terms that builders use. The later revisions have changed the term numbers but everyone still calls it 21.2.1 cover - http://www.self-builder.com/sb3/insurance/21.aspx

jowass

Thanks again for the advice. I have spoken to the claims negotiator from the solicitors this morning, he has advised me to contact L&G and raise a formal complaint and also to demand a second opinion. He is also going to contact them on our behalf to put on some pressure from his side.
Hopefully this will be resolved soon and I will post any further developments.