Insurance voided due to underinsurance. Help please!

dunstonh

Just to clarify my stance, there is no harm in taking the complaint to the FOS in this case. You clearly have a different view on the value of the high risk items than the loss adjuster and you never know, the FOS may agree with you.

I am just pointing out the material that esure seem to be using in responding to your complaint so far and basically positioning it that they do have a point and do appear to be acting correctly in a number of areas. So, not to get your hopes up.

suali_uk

Thanks folks and you have been very supportive and informative. Dunstonh I like your devils advocate approach, and yes they have used word for word from FOS adjudication link you sent. I have already put the complaint in so wait their reply. I am fairly certain they would have accepted my business if I had known the value of the gold jewellery an told them, they would have simply added an extra premium. Thus they should pay my claim as such by deducting any extra premium due. I believe Huckster is right in that the FOS will be aware of othe people they have done this. Also I firmly believe they have just made up this underwriting criteria as there is no where in their policy docs whe it is made clear under what circumstances a policy would be made void eg. If it is discovered more than 1/3rd high risk etc. My feeling is they have done this to use the FOS judgement to justify voiding m policy. Don't know how to prove it other than reliance on the FOS to have some evidence from other claims....

suali_uk

Just received reply to my complaint from sheila's underwriting manager. Despite my complaint being addressed to chief exec for review and a final decision to void insurance and leave to go to FOS if nec. - the underwriting manager reinforces all they have said before and suggests I write again to their customer relations department and states "the customer relations manager will, on behalf of chief exec, review your complaint and respond to you with a final decision". I cannot believe this time wasting game they are playing! I already had the letter from underwriters and asked for a chief exec review and final decision so why are they asking me to do this again?

Anyway, she accepts there was no malice on our part. But states the disparity in my actual high risk items and insured high risk items (£20,250 and £10,000) respectively has been viewed as reckless and a misrepresentation of risk. She reinforces the onus is on the policyholder to ensure that they have selected an appropriate amount for their insurance and that we should have known the value of our gold jewellery. She states again that had they known the high risk and general cover ratio being over 1/3 they would not have offered cover. She states as the proposer we knew everything about the risks and as insurers the knew nothing, reinforcing utmost good faith.

Can't understand why they couldn't make this their final decision as requested rather than repeating everything again and suggesting I write again and request a final decision again!

Any ideas what I do now as both they and I are repeating ourselves?

rs65

suali_uk wrote: »

Any ideas what I do now as both they and I are repeating ourselves?

Are they actually asking you to write again or have they said it will now be reviewed by the Customer Relations Manager?

If they are asking you to write again, just reply saying yes you would like it reviewed by the chief exec (or on his behalf).

suali_uk

Selden wrote: »

I would normally agree, but without wishing to raise false hopes I think there is potentially a case to be made that the insurer is wrong in law - and it would be wise for this argument to be set out clearly at the same time that a final decision is requested.

In reply to the three posts i will answer in order.

yes I have found my moneysupermarket application link and can print this out. I also have sheila's schedule and confirmation of cover email.

Yes they are asking me to write again to customer service manager for final decision when I have already done that, but instead got reply from underwriter reinforcing reasons for voiding insurance again.

As per seldons quote above, how do I set out my argument clearly (legally) in requesting the final decision? Sounds reassuring to hear insurers may be wrong in law.

suali_uk

My points from their letters is as follows:

I don't want to argue website help quotes and policy wording etc. But will point out that I like millions just renew annual insurance getting the cheapest quote and then file docs away once renewed. We don't sit down and go through small print. For example I didn't know about 1/3 max high risk element of cover. I simply thought £30k was for everything and we estimated our contents no more than 30k. Cunningham lyndsey assessed true value to be £37k, which was inflated in my view. so we weren't far off.

Having now read the policy docs in detail it doesn't say anything about what ratio of high risk goods would void a policy though esure state their underwriting criteria allows only 1/3 high risk and they wouldn't have quoted if they had known high risk value at 2/3. They have not provided any excerpt from an underwriting manual to suggest that this is their underwriting criteria, despite quoting many other points.

They accept no malice on our part and this was an innocent mistake, they also accept gold prices gone up but insist onus on us to know value of our contents and insure them appropriately. For this reason they state we have made reckless and negligent misrepresentation of the risk. Without evidence of a written underwriting manual showing their specific criteria I do not accept that they would have declined to offer insurance to us. Thus, I would expect that they charge the extra premium required for extra cover and pay the claim at % underinsured.

huckster

The underwriting manager has not followed the correct FSA complaints procedure. They should not be asking you to write into anyone else. You wrote to the CEO, so she should have replied on their behalf and in the reply she should have confirmed that your complaint had been registered, provided a response and asked you to come back if you were unhappy with the response. She should not have written back asking you to write to someone else. I don't think that is correct.

I think you need to probe the application process that you went through on the Moneysupermarket site and then on the Insurers site you used to complete the purchase of the policy. Were you at any time warned in a clear way about the 1/3 limit on valuables, so you could have considered this. At the moment, you have complained on the basis that you were ignorant of the true value of the jewellery, which I think is debateable as to whether this is reasonable or not. I think a complaint may be more effective if it is about the buying process i.e the information you were given as a consumer to help you buy the policy. You therefore need to spend some time probing the information Insurers provided you when you arranged the policy. If you can make some valid points about that first and then about the increase in gold prices as a further point, I think you stand more chance of a successful complaint.

suali_uk

Hi again, Any suggestions how I should word that request for a final decision including the points above and as per seldons suggestion "... I think there is potentially a case to be made that the insurer is wrong in law - and it would be wise for this argument to be set out clearly at the same time that a final decision is requested."

suali_uk

ok guys how should i word this letter to deal with this properly for final consideration by the CEO/customer services manager. On the money supermarket site i couldnt find anything as you say except a link to terms and conditions and couple of lines saying customer responsible for choosing right cover etc. However, please see below schedule rec'd from sheila's wheels after taking the cover:

huckster

When you entered £30,000, there was an exclamation mark next to this which if you clicked on it would have provided this information.

This is the replacement value for all household goods and high risk items belonging to your household or which your household is legally responsible for. It covers everything you would take with you if you moved.
A third of this total will be allocated to high risk items, for example, if your contents sum insured is £30,000, £10,000 will be allocated to high risk items. High risk items are, for example, jewellery, televisions, mobile phones, DVD players and antiques, and household goods are, for example, tables, freezers and cookers.
It is important that the sums insured represent the full values of the items covered by your policy. Failure to do so could result in your policy being invalid and we may reject or reduce any claim you make or even treat you as being uninsured. It is your responsibility to ensure you keep your sum insured up to date.
The best way to combat underinsurance is by making an inventory, listing each item you own under easy to reference categories. Keep receipts of any new items you buy, as you will be asked for documentation if you need to make a claim. Please remember to use the replacement cost of the items and not what you think they may be worth for re-sale.

I don't like the Esure website. I think some of the layout and lack of some warnings may lead to customers having problems with their cover. There is absolutely no warning to customers to click on the exclamation marks next to data input fields. This is particularly important next to the data fields where you enter the sums Insured. Unless you clicked on the exclamation mark next to the Contents sum Insured, you would not have known what Esure included under high risk items at the point of sale. Yes you could have read the policy, but I would have expected Esure to have made customers read the Contents sum insured explanation notes.

Your complaint could therefore include this, that Esure on their website failed to alert you to important information. As secondary points, you did not realise the value of jewellery due to gold prices and you dispute some of the values entered for high risk items. Due to these factors you dispute why Esure have found it necessary to void the policy, when they could have offered a reduced settlement, based on the customers own assessment of their high risk items.

Edit - Just noticed this was not a new policy and you have had the policy with SW for 2 years. The above is not entirely relevant as you would have seen the £10k limit on high risk items on your documents on several occasions. In a separate point, have SW's sent you a refund for all the premiums paid. If they were voiding the policy, they should have refunded the premiums paid since inception. It might be wise not to accept such a refund, as you have disputing them avoiding the policy.