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

cityfan123

Glad it worked out in the end, and yes, I frequently have the same problem, although the call centres usually have a ridiculously small no. os people for the work they have to do, but then I guess, those dept.s don't make any money do they??

ayva

There are a lot of negative comments about insurance companies on here, and I understand why because if you have had a repudiated claim then you automatically assume that you've been conned in some way - not many people are likely to claim for something they know they aren't covered for...
I work in the claims department of a large insurance company, and I really want to make it clear - I hate repudiating claims, and so do my colleagues. We do this job because we want to make things right, because we care about people and their situations. I've had people crying down the phone at me because a piece of jewellery with huge sentimental value has been lost whilst out shopping & I've had to tell the bereft customer that they haven't purchased cover outside their home, amongst many other situations and my heart has broken for them, but it's up to them to ensure they have the cover they want & feel they need.
At the end of the day, as someone else has said - if you want the cover, BUY the cover. The customer service teams are on hand to go through it all with you if you aren't sure (let's face it, we all know it's not straight forward so get help from someone who's been trained!).
Insurance companies don't decline claims to save money - it's because the cover's not there. If we paid out on claims where the correct cover wasn't in place, the company would be bust before we know it and then you'll never get a pay out!

Katie-Kat-Kins

Yay!! :j

My tips were mentioned in the email!!!!!!! :j:j:j:j

Simplyshush

I had a power cut for in excess of three days (not one of the Dartford lot). It was the hottest weekend of the year so ended up loosing contents of fridge and freezer. The power cut happened in the early hours of a Friday morning so couldn't work on the Friday from home - no landline, no laptop etc. The whole thing was a nightmare, including having to call out my burglar alarm people in the middle of the night when the back up power supply gave up the ghost. Three days without power and finally they connected me to a generator.

With £230 callout charges to alarm company for disconnection and reconnect and new back up supply and coupled with the contents of the fridge/freezer, I thought it was worth making a claim. I have separate companies for both contents and buildings and have been with the contents (DL) for over nine years!

i called to establish whether I could make a claim, they agreed the contents of F/F but told me to contact my buildings insurer re alarm. I was asked to send them a list of the foodstuffs and was made aware that even on this section of my policy there is a £150 excess.

I called my building insurer, I have a normal policy plus additional emergency cover and legals. I was told the normal part of the policy did not cover the call out charges as burglar alarms are not covered. After having this sent in writing, highlighing the section which was their get-out-clause! I called to ask why this wasnt covered under the emergency cover as it clearly stated that 'if I had the need to call out an engineer in an emergency situation etc etc' I seemed to think a burglar alarm ringing constantly in the middle of the night consituted an emergency and warrented an engineers visit. Not the case! They would not accept the claim, burglar alarm engineers is not on their list!!!

In the meantime I sent off my list of foodstuffs to DL, heard nothing for a couple of weeks, had to ring to chase and was told.....due to a high volume of claims etc etc but they would get back to me. A few days later I had a phone call from some arrogant person in their claims department who basically left me feeling that I was totally wasting their time. As I found it impossible to talk to this person without them talking over me, I asked for it in writing. As a matter of coincidence, the following day, my yearly 'automatic' renewal notice arrived so I rang their office and complained about the caller and informed then that I would not be renewing my policy.

After receiving the correspondence I had to call their office and had to remind them that I had already sent the list of foodstuffs as the letter requested that I do so. Holding on for another 10 minutes to their 0845 number, they came back and said can you now have to send the receipts for replacement. This is nearly three weeks after the event and this was NOT asked at the onset. I had to send bank statements to indicate foodstuff purchases as proof and a letter which EDF had provided.

Yesterday, I received a cheque for a whole £53 as final settlement. I contacted them and asked how they have arrived at this figure. I was told that, I have a £150 excess on my policy which they had deducted and as I had received £150 compensation from EDF they had also deducted that from the claim. I asked why they thought they had any rights to the compensation as it was awarded to me, given that I have bills for £230 pounds for engineer call-out charges, an excessive mobile phone bill especially having to call engineers and EDF on 0845 numbers as well as work related calls etc. The compensaton doesnt even cover this nor all the other uninvited expenses and total discomfort such as time taken off work to be at home for connection/disconnection of generator, again for disconnection/reconnection of burglar alarm, take-away foods, driving for 30 minutes to friends just to take a shower etc

I am so totally disolutioned with the sheer arogance of insurance companies so any advice on how to deal with this would be gratefully received.

dacouch

What was the value of the food in your fridge / freezer?

mattymoo

AFAIK they have no right to deduct the £150 that you received from EDF. Very cheeky of them to do so.

It can happen with dual insurance - where home insurance and travel insurance cover the same thing, the insurer that pays out will seek a contribution from the other insurer of half the cost. Also makes sure a dual claim has not been made.

Also happens with compensation claims where an insurer is obliged to deduct state benefits (received because of the injury) from the settlement. The insurer then reimburses the DWP.

In this case, the payment is from EDF for inconvenience. It is not an insurance payout and so dual insurance does not apply. Demand it back.

Kittian_the_Blue

Absolutely agree with Mattymoo, they have no right to deduct compensation amounts from your claim. Sounds like a claims handler who has been trained incorrectly.

Simplyshush

dacouch wrote: »

What was the value of the food in your fridge / freezer?

The value of the claim was just under £400, this was purely contents of freezer and fridge. I had additional bills, over £200 for enigineer call out charges which they refused to accept which is not ok but fine. We wont talk about the massive mobile phone bill resulting from having to make copious amounts of 0845 calls with long drawn out, electronically generated messages to both EDF and Alarm people etc etc or the other expenses you endure whilst in the situation. The fact that I was unbelievably out of pocket already but, coupled with having to pay £150 excess then to add to it by deducting the £150 compensation, I thought it was outrageous.

I could understand it slighly more if I had a cheap policy but I was paying through the nose for contents with DL and for buildings insurance, WITH emergency cover, with another company. I have since changed both insurance companies and I am saving yearly what I paid for contents alone.

mattymoo

Even though you've since left DL, you can still go back to them to reclaim the £150 they appear to have incorrectly deducted.

The only other possibility is that they felt the £400 was overstated. I gather from someone in the know that most fridge / freezer claims are around £100-150. Was it a large fridge / freezer? Apparently some insurers ask the cubic capacity and work out what it could have held. Remember, wine, champers, beer etc can be salvaged so you're only loosing the meat, fish, dairy and salad products plus ready meals.

MrCarrot

I think critical illness insurance tends to be the most vague.

A mortgage advisor told me recently often critical illness insurance is not worth the paper it's written on.

For example, a policy that says it covers you for "loss of arms" could get out of paying if you only lost one arm.

Loss of sight could be argued against if you have say 5% of your sight remaining after an accident.

There was also a case where someone went to the doctors with pins and needles, and the doctor told him it was pins and needles and everyone gets it. Some 20 years later it turned out he had MS. Insurance company wouldn't pay out because his doctors records showed that 20 years earlier he complained of pins and needles and didn't declare this when he took out the policy!