Great 'How to ensure your insurer pays claims' Hunt: How to assure a payout

Droop

LadyIndecisive wrote: »

Dacouch - I didn't know that re Chaucer, that is surprising.

Droop - why don't you choose to pay for the information available on you on CUE, instead of expecting your new insurer to do it?

£10.

If I was aware of this beforehand I certainly would have done.

jaxs

Many years ago, the flat roof on part of my house leaked when we had a horendous downpour. The rain was running down the walls and coming through the light fittings. My husband was away so I moved whatever I could out of the room (to stop any damage to them), turned the electrics off and called the insurance company as I was panicing. I spoke to a really, really helpful lady who took down all the details and basically said there would be no point in me calling a builder out as it was dark, so they wouldn't do anything. Anyway, I had to spend the night changing buckets and bowls and hopeing the roof didn't come in.

I called the insurer back the next day to be told they wouldn't be paying out anything as there hadn't been any rain in our area the previous night! I was flabergasted and asked where they got their information from. Was told it came from the Met office. I rang them and indeed they said there wasn't rain in our area. I went back to the insurer and asked them to send an assessor round to see the damage the rain had done - they didn't want to know anything about it.

I couldn't believe it. I knew I wasn't lying - you could clearly see the water damage on the walls and ceiling and the smell of damp carpet was unmissable! The claim wasn't for a huge amount but they made me feel like a criminal for doing nothing wrong!

I probably should have fought this, but the policy came up for renewal a couple of months later and funily enough, I moved to a different insurer!

Katie-Kat-Kins

Tip - take photos of all damage, it is much more difficult to dispute a claim backed by photographic evidence. You can also get witness statements from people who have any relevent information, in this case you could have spoken to your neighbours who could have confirmed the weather.

To be honest the met office will only be able to confirm the weather at their nearest monitoring station not at your precise address so I think that refusal of the claim sounds a bit of a fob off but maybe there were other factors.

Mungbeanz

I agree that reading policy wordings is essential for knowing what you are getting cover for. However one fundamental reason for buying insurance is to cover the unexpected. So as much as you can understand English and thorougly read the policy's T&C's AND more importantly the exclusions, often you won't know that you need cover for until the inevitable happens.

E.g. who would have expected a number of airlines / travel groups to go bankrupt last year? We only know now to read policy wordings to determine if bankruptcy of travel providers is covered following a number of high profile examples last year. Though luckily in this situation there are other possible solutions for recourse.

I guess the best advice I can give is come up with worst case scenarios for whatever you are seeking cover for, then ask the insurer to confirm what you would be covered for under the scenarios. insurer's use the same tool i.e. scenario analysis, when determining what insurance to cover themselves too.

dacouch

jaxs wrote: »

Many years ago, the flat roof on part of my house leaked when we had a horendous downpour. The rain was running down the walls and coming through the light fittings. My husband was away so I moved whatever I could out of the room (to stop any damage to them), turned the electrics off and called the insurance company as I was panicing. I spoke to a really, really helpful lady who took down all the details and basically said there would be no point in me calling a builder out as it was dark, so they wouldn't do anything. Anyway, I had to spend the night changing buckets and bowls and hopeing the roof didn't come in.

I called the insurer back the next day to be told they wouldn't be paying out anything as there hadn't been any rain in our area the previous night! I was flabergasted and asked where they got their information from. Was told it came from the Met office. I rang them and indeed they said there wasn't rain in our area. I went back to the insurer and asked them to send an assessor round to see the damage the rain had done - they didn't want to know anything about it.

I couldn't believe it. I knew I wasn't lying - you could clearly see the water damage on the walls and ceiling and the smell of damp carpet was unmissable! The claim wasn't for a huge amount but they made me feel like a criminal for doing nothing wrong!

I probably should have fought this, but the policy came up for renewal a couple of months later and funily enough, I moved to a different insurer!

Call it a lucky guess but your were with Halifax.

There are ways to fight a claim that is denied when the Insurers say their data supplied by the Met office said there was no rain etc. This is because they normally rely on data from a weather station many miles away. The Ombudsman will often rule this data as not acceptable.

For the record heavy rain coming through a flat roof is not normally something that is covered. The Insurers will not normally replace / repair the roof as its generally wear and tear. They will however normally pay the damage the water has done to the rest of the home / contents especially if you have Accidental Damage Cover

dacouch

lisyloo wrote: »

Just a wild and crazy idea, but what about using a professional with decades of experience who can give you this information.
Often for nothing.
Obviously the best companies may not be the cheapest.

Do you mean information like this Lisyloo?

http://www.instimes.co.uk/story.asp?storyCode=376295

I would say this survey would agree with my experiences although I personally would place Groupama and MMA lower (Funnily enough they are French as are Axa) and also Allianz lower.

Please note if you read this survey bear in mind its a survey of brokers so will not include companies that do not deal with brokers eg Direct Only companies such as NFU, CIS, Direct Line etc etc

unionjack81

Don't exaggerate the claim!!

A little exaggeration of the amount of the loss will be considered to be a starting point for negotiation. However, if your insurer suspects and proves you have fabricated or grossly exaggerated any part of the claim they have the right to refuse to pay every part of the claim (including the parts of the claim that are legitimate). Not that anyone would be so dishonest? :rolleyes:

Also, be polite and courteous to the claims handler you are dealing with. Quite often, insurers, even though not obliged to do so under the terms of the policy, offer an ex gratia payment to the policyholder. An insurance company is a business but the people who handle the claim and make the ultimate decision on what action to take my take pity on you – they are human after all!

cogito

unionjack81 wrote: »

Don't exaggerate the claim!!

A little exaggeration of the amount of the loss will be considered to be a starting point for negotiation. However, if your insurer suspects and proves you have fabricated or grossly exaggerated any part of the claim they have the right to refuse to pay every part of the claim (including the parts of the claim that are legitimate). Not that anyone would be so dishonest? :rolleyes:

Also, be polite and courteous to the claims handler you are dealing with. Quite often, insurers, even though not obliged to do so under the terms of the policy, offer an ex gratia payment to the policyholder. An insurance company is a business but the people who handle the claim and make the ultimate decision on what action to take my take pity on you – they are human after all!

Not so. The words ex gratia are unutterable in insurance companies nowadays and any claims handler giving his employer's money away would soon find himself in big trouble. Claims handlers do however try to be creative and flexible in their interpretation of policy terms and conditions and stretch the policy wording as far as they can when the circumstances justify it.

In one recent case that I encountered, there was an argument in favour of making a payment where the loss was technically excluded. The insurers solved the problem by allowing a return of premium rather than deal with it ex gratia.

Katie-Kat-Kins

Exaggeration should never be used even in negotiation. Your starting point for negotiation should be the highest legitimate sum, so if your car is valued at £8 - £10k you start at £10k not £11k, unless you believe that there is a reason for your car to exceed the standard valuation.

Exaggerating a claim is fraud and is increasingly being dealt with as such by insurers. It can lead to your whole claim being repudiated and worse potentially even criminal investigations.

cliveoram

We all hate having to pay insurance and I have always tried to get the cheapest quote possible in true MSE style. However, I have had a motor claim problem (they "wrote off" a lightly damaged car and would only allow me to have it back if I agreed to withdraw the claim and pay the costs - which were more than the amount they were prepared to pay me on the claim), and recently we had a claim for damage to the house and the IC insisted on their own contractors who came from 50 miles away and were such cowboys they did more damage than they fixed. Because I did not have photos of the room BEFORE they wrecked the decoration no-one would discuss compensation.
From now on I shall only deal with companies who use local assessors - NOT Asprea or other companies who are paid a bonus for rejecting/reducing claims.