SAGA insurance problems

photome

Hope someone can help

My parents had a leaking pipe under their sink unit in the kitchen,they woke up one morning and the floor was flooded so it ruined 1 unit and the lino on the floor.

They are insured with SAGA who sent out an "assessor" 10 days later, who told them that the pipe had been leaking for a while so he would decline their claim.

They didnt know it had been leaking, if they had they would have sorted it.

They have been on the phone to SAGA about 3 times and keep getting told that they have to deal with the company who came out to look at the problem (sorry cant remember the name...Asprea or something similar) who are paid by SAGA and who have declined the claim.

Basically they are getting nowhere, I have advised the ombudsman on monday but not sure that is the right course of action.

IMO I cant see how the insurer can fail to pay out for a leaking pipe irespective of how long it had been leaking .

Anyone any ideas please

Edit , just googled Saga and it seems my parents are not alone in their problems with SAGA/ASPREA

*MF*

Starting here, ok.

If you go to this link:

http://www.saga.co.uk/insurance/policy-documents/

You can download a pdf of the policy cover Saga use, and it includes this:

Water or oil as a result of a burst, leaking or overflowing domestic water or heating installation, appliance or piping. This includes damage to any water installation caused by freezing or bursting.

So on the face of it, there is cover (will be pleased to hear from other regular posters on here - if they agree - or not).

I also think what you have been told about the procedure for an approach to the Ombudsman is incorrect - as best I know it - an approach to the Ombudsman can be made only AFTER the Insurer - NOT an adjuster - has finally refused the claim (again would like to hear from other regular posters if they would agree - or not)

So, all that having been said, what to do?

Well, were it me, I would start by quoting the above cover (the bit in red above) to the adjusters, and ask them if they have a different version, and if that doesn't get you further forward - then ask them to put in writing - 1) the cover they are working to which relates to water leakage 2) any exclusions of cover they may be using and 3) very very precisely why they are saying there is no cover. Make sure you get it in writing - for eventual use with Saga, and perhaps the Ombudsman.

See where that takes you, and if not very far, post again on here - I am sure there will be help available here - if not from me, from many of the other regular posters.

Miss_Qwerty

I don't know about the decision about declining the claim itself, but I do know a little about the Ombudsman.

MF is right, they wont really look at it yet until you've gone through the Saga complaints process. You need to give the insurance company a chance to deal with your complaint first. So what they will do is just contact Saga and say "We've received this complaint, can you review it".

The Saga complaints team should then look into and whatever result they come up with they will send you a letter with a "Final response" in it. Once you receive their final response if you're still not happy with then you can go to the ombudsman and they will get all the facts from both parties and make a decision on whether it was the right result or not.

Quentin

*MF* wrote: »

You can download a pdf of the policy cover Saga use, and it includes this:

Water or oil as a result of a burst, leaking or overflowing domestic water or heating installation, appliance or piping. This includes damage to any water installation caused by freezing or bursting.

So on the face of it, there is cover........

All policies have a catch all condition excluding wear and tear and "gradual deterioration" (or similar wording to exclude things that would be dealt with under normal maintenance) which will be what the grounds for rejection here are.

*MF*

Quentin wrote: »

All policies have a catch all condition excluding wear and tear and "gradual deterioration" (or similar wording to exclude things that would be dealt with under normal maintenance) which will be what the grounds for rejection here are.

Accepted - but, lol.

How many of us (I do) store things like washing powder, cleaning cloths, newspapers, etc., under the kitchen sink - all of which are in reasonably constant use, even if not daily, and all of which are susceptible to water leakage.

It is just my opinion - but to hold to gradual deterioration (where a unit and lino) have been damaged in what seems to have been "an incident" which was anything but gradual - is a misuse of the maintenance aspect which as I say - I accept.

But again, I repeat my main recommendation to the OP - as in 1,2 and 3, above - let's get the adjusters to commit to paper - in detail.

Quentin

You seem to be shooting the messenger.

I pointed out the exclusion that they are probably relying on, that's all! (You did say you'd be pleased to hear comments!)

*MF*

@ Quentin

Apologies, not my intention, sorry if it came over that way - and maybe the to and fro will help the OP

FlameCloud

*MF* wrote: »

But again, I repeat my main recommendation to the OP - as in 1,2 and 3, above - let's get the adjusters to commit to paper - in detail.

Saga haven't sent out an adjuster though.

It can be a tricky one this- the only real way to deal with a claim such as this is to gauge basically whether you think the policy holder is telling the truth or not, and match it with the damage that you see in front of you.

For example, a leak from a sink feed pipe- i.e. in the cupboard under the sink is one I will never believe will go unnoticed, because as you say people are in there pretty much daily and thus either deliberately ignore the problem or do something about it. It is fairly easy to tell how long something has been ongoing for from the amount of damage caused.

photome

FlameCloud wrote: »

Saga haven't sent out an adjuster though.

It can be a tricky one this- the only real way to deal with a claim such as this is to gauge basically whether you think the policy holder is telling the truth or not, and match it with the damage that you see in front of you.

For example, a leak from a sink feed pipe- i.e. in the cupboard under the sink is one I will never believe will go unnoticed, because as you say people are in there pretty much daily and thus either deliberately ignore the problem or do something about it. It is fairly easy to tell how long something has been ongoing for from the amount of damage caused.

Thanks for all replys

I tend to agree about noticing a leaking pipe, but what I do know is that my parents went to bed with no visible damage in the kitchen and woke up to find water everywhere.

I will get them to check policy wording and thec get SAGA to put in writing their reason for refusal

The problem they are up against now is that SAGA keep telling them it isnt their problem and that they have to deal with Asprea...who wont contact them. The way I see it is that it is definitely Saga,s problem

My paarents are pensioners and not great at dealing with this type of problem