The Great 'How do insurers decide whether to pay out?' Hunt

twins_2_Be

My TV died and it will be £215 to fix it (I have to pay the first £100) so I will get £115 from Royal & Sun Alliance (via Tesco).

Am I silly for claiming for £115 as it might make my premiums go up? I have not claimed for over 5 years and then it was about a £300 claim.

andria_53

Hi

I work for an independent financial adviser and deal with life insurance, critical illness and healthcare insurance.

My advice would be to avoid like the plague the policies you see advertised on the TV that tell you you don't need a medical and that you will be accepted straight away without disclosing your medical notes.

In the event that you need to make a claim (I deal with death claims and critical illness claims etc), the insurer will pull apart the medical history of the insured bit by bit so if they are fully aware of medical history when the policy is accepted and issued they cannot reject any claim. And THEY WILL pull any claim apart so it is always best to take out any of these policies with full underwriting. The downside of disclosing any existing medical condition is that they may rate the policy which means they may bump up the monthly premium you pay but at least you know it's covered. The hotspots for rating of policies are: Blood pressure problems, being overweight, back problems and diabetes. Strangely, heart problems such as angina do not normally seem to attract great weighting of policy premiums as the health conditions above do.

What they also don't tell you on the cheapie policies is that unless you put the policy under trust (for your loved ones, family) at inception any payout will go straight to your estate and will be taxable. If it's under trust, it will not. Any quality insurance broker will tell you this.

Final words, for something as important as providing for your family or children in the event of your death, it's always worth paying just that little bit more to have the peace of mind that they will pay out.

Nutty_Tart

Tesco Insurance wouldn't pay out for a water leak I discovered after having a meter installed and receiving a bill for over £1K. I had to get a plumber to install a new pipe from my side of the meter to the stop !!!! in the kitchen (under the front garden, under the front of my house through to the kitchen in the back!). Cost a fortune & still paying it off! The paperwork I received said I would be covered, but the people on the phone said no. However, they did say that if I had been racing diggers on my front garden and the pipe was damaged from that, then they would pay out! I am not with them anymore! Had previously had my car insurance with them aswell, but switched because of poor service and their 'can't be bothered' attitude.

smiffy

My car was recently damaged while stopped at a pedestrian crossing. The other driver admitted full responsibility and her insurance paid for repairs to my vehicle.

I've now begun the process of renewing my insurance and have found that the Admiral group want to charge me almost £60 a year more as a result of the "claim". I'm quite insistent that I’ve not made a claim as the other insurance company paid out in full, no claim forms were completed, and I did not even claim from my insurer either.

I'm not best please - so I've written to the other parties’ insurer and requested compensation for the increase premiums I now face due to their customers’ carelessness.

silverfoxuk

andria_53 wrote: »

.......in the event that you need to make a claim (I deal with death claims and critical illness claims etc), the insurer will pull apart the medical history of the insured bit by bit so if they are fully aware of medical history when the policy is accepted and issued they cannot reject any claim. And THEY WILL pull any claim apart so it is always best to take out any of these policies with full underwriting. The downside of disclosing any existing medical condition is that they may rate the policy which means they may bump up the monthly premium you pay but at least you know it's covered. The hotspots for rating of policies are: Blood pressure problems, being overweight, back problems and diabetes. Strangely, heart problems such as angina do not normally seem to attract great weighting of policy premiums as the health conditions above do.
Final words, for something as important as providing for your family or children in the event of your death, it's always worth paying just that little bit more to have the peace of mind that they will pay out.

One broker markets themselves as specialists in helping those with 'conditions' get insurance by speaking with underwriters on your behalf to see what (if any) loading would apply. I have never dealt with them so have no idea if they are good or bad, but they have a blog which is reasonably informative:
http://www.theinsurancehelpline.co.uk/blog/
A good IFA would of course offer the same service.

Jacqui_Stone

My close friend has had her vehicle written off, by a car setting alight through an electrical fault apparently, and with the wind assisting, went on to set alight 5 cars parked alongside, including hers.

It was a 7 seater Nissan, and as a single parent with four kids she relied on it completely. It wasn't new by any stretch of the imagination, however, she has only now been offered £200 approx. for the car, for which she has no chance of trying to get a replacement. The company have said that she will have to a) deduct the excess - of £100 which is fair enough but b) also the premiums she would have had to pay to the end of the year when her renewal would have been due - she paid monthly.

They have also said that it is only looking at what the vehicle was in their eyes worth - £500 - not the cost of getting a similar model, and we believe they are substantially under valuing the car, as looking on auto trader and ebay we can't find any car or that model or similar for anywhere near the money they are talking about.

In addition, they have also now said that they may not pay out at all because they have found out the car had been written off in the past. She had bought it in good faith, and had it MOT'd etc and on checking with the DVLA, it had been certified as roadworthy and been relisted. She paid her premiums always on time etc.

Anyone got any ideas? Any help would be very much appreciated.

Sandgrown

I am currently claiming for damage suffered in the earthquake that hit Folkestone in April. The loss adjuster has said that there is only minor superficial damage and has suggested we accept a one off payment of £2000 and arrange for the work to be done ourselves. What worries me is that several houses either side of ours have suffered major structural damage and without a survey by a qualified structural engineer, how does the insurer know if there is something more serious present? The problem is compounded by the house being part rendered so it is impossible to detect if there are any cracks in the brickwork beneath the render. Finally, we have admitted that some cracks in walls were there prior to the quake but the loss adjuster is insisting that because he cannot be certain that some of the damage was caused by the earthquake then he cannot pay out for this. I would welcome any thoughts/ideas.

inertmale

I insure my pet dog with Direct Line and made a claim for the removal of some lumps from the dog. Because the vet report said "removal of lumps,cysts and lipomas" the insurance took three lots of excess from me leaving me £180 out of pocket even though the dog only had one operation! Surely this is an unfair interpretation of my policy.

tmboxster

A tile recently slid off my roof and onto the bonnet of my car causing a five inch stratch and small dent - household insurance - Norwich Union are not interested and told me to claim from my car insurance for which I have a £600 excess. This doesn't seem right considering that NU will have to pay the car insurance they are just trying to save £600. As it was a part of the house that caused the damage I think that I should be able to claim under this policy. I have never made a claim before and will now move my insurance elsewhere!

olly300

Due to the number of complaints about not being treated fairly.

Can any of you who have worked in insurance give posters information of the steps to complain with approximate timelines?