claim repudiated after work started - please help

badgerpig

Hi,

we have 2 houses and spread time between the 2 normally 2-3 weeks at a time due to work commitments. We had a burst pipe during December causing a bit of water damage, wet carpets, walls, etc but no fallen ceilings,
we called insurance who said they would send out a loss adjuster, a cleaning company (rainow) brought dehumidifiers, heaters and fans and removed all loft insulation, carpets, light fittings, white goods (fridge & dishwasher), kettle, microwave, etc etc from the house

After 2 months of excuse after evasive excuse from insurers, wasted phone calls and stress, the insurance company are repudiating on the grounds that house is unoccupied/unfurnished (even though the loss adjuster visited after the house was emptied by rainbow)
we have explained the circumstances but the insurance company seem to try every excuse in the book so not to pay

my question is if they refuse the claim are they obliged to replace the carpets etc and pay for all the electricity used by dehumidifiers/heaters and fans on 24/7 for 2 months?

they have made the house considerably worse by partially completing repairs?

thanks

huckster

Suggest that you get the ball rolling by making an official complaint in writing using their complaints process. Ask them to provide a full explanation in writing about all the issues you want them to explain.

In the letter make it clear to them that you will be happy to let the complaint be looked at by the FOS. If you went to the FOS, they would get charged a £500 case and it could cost you nothing. So the Insurers might start to be more helpful, if they think you will go to the FOS.

Sounds like the claims was agreed in principle based on first information and after investigation they cannot see that you declared the occupany position when the policy was taken out. You should have told them about the situation, living between two properties.

badgerpig

huckster wrote: »

Suggest that you get the ball rolling by making an official complaint in writing using their complaints process. Ask them to provide a full explanation in writing about all the issues you want them to explain.

In the letter make it clear to them that you will be happy to let the complaint be looked at by the FOS. If you went to the FOS, they would get charged a £500 case and it could cost you nothing. So the Insurers might start to be more helpful, if they think you will go to the FOS.

Sounds like the claims was agreed in principle based on first information and after investigation they cannot see that you declared the occupany position when the policy was taken out. You should have told them about the situation, living between two properties.

thanks Huckster, Ill write to them today, we did tell them we were lving in two houses, we spoke to the broker in August who advised us to keep the policies as was and that the house was OK if we were using it more than once every sixty days

huckster

badgerpig wrote: »

thanks Huckster, Ill write to them today, we did tell them we were lving in two houses, we spoke to the broker in August who advised us to keep the policies as was and that the house was OK if we were using it more than once every sixty days

The broker might help you in this situation. If they speak to the Insurers claims department to advise that they were aware of the occupancy, this might avoid you needing to write. Might speed matters up in the right direction.

Quentin

badgerpig wrote: »

the insurance company are repudiating on the grounds that house is unoccupied/unfurnished (even though the loss adjuster visited after the house was emptied by rainbow)
we have explained the circumstances but the insurance company seem to try every excuse in the book so not to pay

When you explained their mistake over believing the house was both unfurnished and unoccupied, what was their answer?

It seems this is their reason for declaring the policy invalid, but from what you tell us this unoccupied/unfurnished statement by them is completely untrue, and should have been easily corrected - or have they other reasons?

If not, you have been very patient, and why were no arrangements made for temporary rehousing?

badgerpig

Quentin wrote: »

When you explained their mistake over believing the house was both unfurnished and unoccupied, what was their answer?

It seems this is their reason for declaring the policy invalid, but from what you tell us this unoccupied/unfurnished statement by them is completely untrue, and should have been easily corrected - or have they other reasons?

If not, you have been very patient, and why were no arrangements made for temporary rehousing?

Hi Quentin,

we've explained many times over the last 2 months and they accept our information one week then another party disputes it the next, its been one error by them (NIG and Crawfords)after another, there are currently 5 intermediaries involved all blaming each other for delay, they originally made a decision on the loss adjusters report then realised the cleaning company had removed everything before the report was made so the report was void, we even have photos (datestamped) of us staying in the house in November, they told us they wont pay for alternative accomodation until the claim is accepted

last update is that there is an internal investigation to be resolved by Tuesday next week,

Quentin

Have you escalated this with the insurer? (Not the intermediaries)

Under normal circs, people don't have another home to go to, and wouldn't have been able to survive all this time without alternative housing being arranged.

You have been far too patient, make some noise in the right places!

badgerpig

Thanks for the advice I am writing to them now

magpiecottage

Quentin wrote: »

Have you escalated this with the insurer? (Not the intermediaries)

Quite so. Anybody the insurer appoints in these situations (as opposed to consenting to you to appoint) is the insurer's agent.

Telephone tomorrow. Get the name of the person you spoke to and note the date and time.

Tell them you are making a complaint about the way the complaint has been mishandled.

They may tell you to put it in writing and/or to write in. Politely point out that the FSA has said that insurers are responsible for the actions of anybody they appoint to act for them and that complaints can be made verbally.

Explain that they have eight weeks from receipt of the complaint to respond to it and that eight weeks has just started!

deutsch

was the burst pipe due to the cold/freezing weather in december? if you occupy the house, do you have the heating on? maybe your gas bill will be proof that you occupy the house regularly. just a suggestion...

badgerpig

Thanks to all who replied, it was good to have some support while this was going on!
For info, the insurance company refused to pay, except for drying the property. They tried different ways to repudiate the claim, firstly that it was unoccupied, then unfurnished. Finally they decided the brokers made a mistake by issuing the wrong policy. This took 3 months and we are now being offered £5K by the broker towards the damage or go to the ombudsman for the full amount which was originally £22K but we now think is nearer £12K.
Lessons learned, turn off the water if a cold snap is forecast and you are going away. Make sure you have the right insurance if you use two or more properties.
Also we took notes from day one, which was useful when corresponding with both the insurance company and the broker.