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

purplecatlover

i claimed on my house insurance for replacing my laminate flooring after my washing machine leaked last year. they sent someone out, agreed the floor was damaged and arranged for it to be replaced from back door to front door since it ran through kitchen and living room wihtout a break. they also repainted both rooms as they had to take the skirting boards of to lay the new flooring.

i got to choose the flooring and the paint i wanted, though the decorated wasnt allowed to do my ceilings or anything other than paint the walls

my premium only went up by 3 pounds on renewal last month.
norwhich union, arranged by swinton. i was impressed, esp as i rent and thought i was going to ahve a real battle over if it was down to my contents or my landlords building insurance to cover it.

hoathfarm

bouncydog1 wrote: »

V interested in your post as just about to effect renewal and considering NFU.

Looking at their policy conditions for loss of animal, it is covered if animal is put down on humane grounds without NFU's written consent provided vet certifies that the injury, illness or disease is incurable and the suffering so excessive that...to delay would be an act of cruelty.

Putting down on humane grounds is also covered with NFU's prior written consent, which does not have to be carried out immediately.

What does your vet say?

If your vet certified that she should be put down then I should appeal to NFU or following that the financial ombudsman.

If you took the decision to have her put down without vet certification then I guess they are declining the claim because you did not follow policy conditions.

My normal vet x/rayed her and sent plates to another vet for confirmation of problem, they both said she had to be put down, then when my vet contacted NFU and their consultant vet said no. I then took her took another vet for further x/rays and was told she should be put down either there and then or in a couple of weeks, I could not put my horse through the trauma of another journey so agreed to have her euthanized that day. According to NFU because the horse could still stand and graze she did not qualify to be put down, apparently she did not fall into the category of 'destruction due to inhumane suffering' according to the BEVA guidlines. Has anyone any ideas on how to beat these so called advisers at these insurance companies.

Bollinge

Jacqui_Stone wrote: »

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.

Suggest your friend speaks to Mr. Bob Bull, @ Midlands Claims Recovery, who is a Motor Insurance Facilitator, specialising in this kind of thing.

http://www.midlandclaims.co.uk/

FlameCloud

mattymoo wrote: »

Nothing personal FlameCloud, I know this is your job, but I have a very uneasy feeling about this power you have to view a customers accounts like this. No doubt it is covered in a contract term relating to sharing of information within the group but it does seem to be a touch big brotherish.
The other issue is the interpretation of that data. We use forensic accountants on major commercial BI claims (Business Interuption / loss of profits) and they hold all the relevant qualifications to do this work. Who is interpreting the bank account data in these cases?
At the moment I guess I can breath easy, I bank with Nationwide and insure with More Than and they do not have a financial connection. It does make you wonder about Direct Line / Churchill / RBS / Natwest / HBOS though.

For what its worth, I agree with you about the big brother stuff. When I first started working there I was shocked about what they could access!

As for analysing the information, it is just down to personnel preference really. Everyone with access to it holds financial qualifications to some degree. Normally, I try and compare it to my own financial situation, which I would probably regard as the 'norm' (Rent/mortgage, car loan, about £500 on a credit card, acount about £500 in the black). I use it mainly for people that normally demand a cash settlement, as there is a lot less fraud where we replace stuff directly.

It is used as a tool, like everything in the job. Very rarely can one indicator ever prove a whole claim, and a poor bank account is no indicator of fraud on its own, but, for example, combine-

Close (less than a year) Inception.
Demand for cash for high value items that we could replace
Questionable circumstances (its amazing how many tv's just fall over)
Poor VFM/Aquilo report
No money.

Then we would take it further.

Andy_L

Fairbs1983 wrote: »

As your children used the pen to damage all items (the camera and TV is different as the pen was presumably put down in order to throw the camera), at the same time, the Insurance Company has an obligation to honour it as one claim. T

Would they not just refuse anyway as it was a deliberate act by a member of the insurred household?

davesdebt

Hello to all.

I have made several claims for insurance, House Car etc in the past. I tend to find that at the first point of contact, regardless of the claim or the situation the insurance company will tell you it is not covered or that an excess is due or the circumstances were incorrect etc.

My advice would be to persevere, write to the company, inform a solicitor and keep notes of all correspondance. I also advise asking to speak to a supervisor/manager in the event that representative that you get to first is unhelpful, keep up the pressure (as long as you are in the right) and you will eventually win.

Good Luck

andria_53

schoolfundraiser wrote: »

I heartily endorse all of that as I am still waiting for the payout on our expensive joint £22K life policy (taken out 14 years ago when my husband was a smoker which was disclosed and younger and fitter ) 10 and half weeks after his death from a very sudden and unexpected heart attack. (He had to have a post mortem to determine whether it was natural causes which it was.)

The insurance company took 4 weeks to ask for a medical attendant's report from his GP and by the time the practice received the request they had sent back his paper notes to the health authority for storage having held on to them for a month as is normal practice. So of course his notes can't be found. Not that they would help as he was in good health - normal cholesterol levels normal blood pressure and he had given up smoking six years ago and only went to the docs with such as a bad foot (went to casualty for an X-ray just sprained etc) and sinus infection after a cold.

To get the insurance company to do anything to speed it up to get it to the underwriter stage I had to cry down the phone (and believe me by this stage I was a nervous wreck living on my credit cards with no income coming in at all and funeral expenses needing to be paid). But two weeks later I am still waiting and my complaint is drafted as I kept copious notes of all telephone conversations and the gp practice manager has been most helpful with dates and procedures etc.

Needless to say I won't be using this very well advertised and well known company again ever. There is a reason they advertise so much on the TV - they must need to get new customers all the time as they certainly don't do anything to keep their old ones.

:eek:

It is hard enough being widowed without the money problems it causes - your husband's bank accounts are frozen your child tax credit ceases until you reapply your income drops dramatically and you're having to print money to pay for the funeral. Then the insurance companies start taking the mickey on the policy you have paid out on for all those years!

Hi there Schoolfundraiser

I am sorry you find yourself in this situation. Sadly, this is a common occurence with insurers dragging their heels when investigating claims, something which you don't need having just lost your husband.

All I can advise you to do is fight and if need be take it to the Financial Ombudsman Service. There is so much work entailed in following up a complaint that this MAY nudge them in to paying out.

Did you take the policy out directly with them or through a broker? If you took it through a broker then they should be dealing with them on your behalf.

I hope you get it resolved soon.

Voyager2002

RibAd wrote: »

Often claims are declined on basis of the necessary paperwork not being returned with the claims form. This can be anything from evidence like booking invoices of air tickets and accomodation, to receipts of the items claimed, to the insurance certficiate itself. Failure to produce these pieces of information will result in the claim being declined.

I am at a loss to understand why insurers need booking invoices for air tickets and hotels. I generally arrange my accomodation locally, often staying in small places where payment is on a cash basis, and so could not provide this kind of documentation.

The last time I had to make a claim, it was only when I requested a claim form that I was told that such details were relevant. I had obtained a police report relating to the loss (theft on public transport) and had kept receipts for the items that had been stolen. But I was asked for the kind of documentation that would only have been provided with a package holiday (itinerary, etc): surely travel insurance is for different kinds of travellers!

Voyager2002

RibAd wrote: »

Often claims are declined on basis of the necessary paperwork not being returned with the claims form. This can be anything from evidence like booking invoices of air tickets and accomodation, to receipts of the items claimed, to the insurance certficiate itself. Failure to produce these pieces of information will result in the claim being declined.

And why does the claimant have to provide the insurance certificate? Surely the insurance company keeps records of the policies they have issued: or perhaps this is a way to save money on filing?

insured

Hi Flamecloud
These are excellent and informative posts.
I