insurance won't pay out

m1ch43l_2

we moved into our house in aug 12 and not long after started to have problems with the boiler losing water pressure. We also noticed water stains appearing on one of the walls downstairs. We had a plumber check for obvious leaks but he couldn't find any, and because the boiler was still under warranty, we called them out. They checked it and couldn't see that anything was wrong but replaced a part, saying if this doesn't work you must have a leak somewhere. It still kept losing pressure every 5 days or so, so i called insurance to explain and ask for confirmation that we had trace and access cover, as i thought it might be a internal leak in the wall. They told me i did have it and so i arranged for a company to come out and perform a survey. They did this but the conclusion was inconclusive, as they said that when they put gas through the system they should detect a lot more than what they did. They also thought the water stains may be unrelated, possibly due to condensation. Their bill was £800. When i called the insurance company back, they said that because no definite leak was detected i was not covered and would have to either pay the bill or risk getting them out for further exploration, which i would also have to pay for if no leak was found. I thougt i had acted in good faith and tried to eliminate the options, i don't feel it is fair that they will not pay out. I have looked at the booklet they sent with the policy and it doesn't mention if a leak is not found. Do i have grounds for an appeal ?

Quentin

An appeal won't cost you anything (apart from a stamp), so always worth a try.

Send it as a complaint, using the insurers complaints procedure set out in the policy.

Then if you are unhappy with their reply you can escalate to the FOS at no cost to you.

That way you will know if they acted correctly refusing your claim after telling you that you were covered!

TSx

Most policies word the trace and access in such as a way that it only covers you for tracing and finding a leak which results in damage to the buildings. If the leak hasn't been found, then they are correct in saying they don't know if there is cover or not.

The insurer I work for in this situation would generally pay for the cost of sending out someone to either trace it as being a leak (in which case the bill for £800, any remedial work and the cost of the people the insurers send out would all be covered). If it turns out to be rising damp, and there is not a leak, we would not cover for any remedial work but would not charge you for the investigation.

Unfortunately, some insurers do charge for investigative work when the eventual problem turns out not to be covered.

I am quite concerned though - for £800, I would have expected a lot more than them to just say that there is less tracing gas going through the system than is expected. If it's a hot water leak, they should be able to thermally image the leak.