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

georgeone

worto03 wrote: »

With my house insurance they have said that they will pay for the work as long as the quote is for less than £500 without sending an assessor out. This is due to storm damage.

My mate tried to claim for storm damage for something else but they checked his post code against a database and said that there were no storms in the area that week so woulnd't cover it.

So if your trying to get storm damage through make sure you wait for a storm, don't claim in the middle of a nice summer month.

worto.

This sounds like you are suggesting people commit fraud. Also sounds like your friend tried to submit a fraudulent claim - and pretty incompetently too!

agal

dunstonh wrote: »

House insurance wont cover you for mechanical failure. That isnt what it is for.

Perhaps the alternative view is that if you pay cheap, you get cheap. Some of the plans that have cheap premiums have so many features or options removed or more exclusions added that it is barely worth paying for it at all. Pay a little more for a decent plan and you get much better value you in the long run.

Money saving is about value for money. Not about paying as little as possible for rubbish.

I take an alternative view when it comes to house insurance. I only want disaster cover - if my house burns to the ground I can't recover financially. On the other hand a roof-tile blowing off or a football through a window is just part of life's rich tapestry and I wouldn't expect to make a claim for such minor mishaps. Consequently I pay £140 p.a. for £1000000 B and £50000 C without any bells and whistles.

RibAd

harryhound wrote: »

This thread is highlighting travel insurance as a mine field.

I do understand that a contract with an insurance company is one of "utmost good faith" ie we have to answer questions the company forgets to ask (because the company is 100% on our side in any claim:rolleyes: :rolleyes: :rolleyes: :rolleyes: :rolleyes: ) HOWEVER these days insurance is bought over the internet, so there is no chance to explain something like "I've been taking an aspirin a day for 20 years" and the computer would not understand.

My lifetime claim history is car accidents in '68 & '71 and a house structure claim for a back door battered down by a burglar in '97, so I have not got a lot of experience in making claims.

My brain knows I'm still about 27, as long as I don't look in a mirror. But in reality Mrs Hound and I are "third age" material and this year we are going outside Europe for a holiday. Filled the forms in on line, data accepted.

Then Mrs Hound started fretting - about 18 months ago the family doctor called her in for a "well woman" check and said "If your blood pressure stays where it is I will have to put you on medication". Mrs Hound promptly lost a couple of stone and now has normal blood pressure BUT is she covered for dropping dead with a heart attack ?
So dodging round the 0870 number, I telephoned and found myself talking to someone who sounded pretty professional (ie not a call centre muppet reading a script). He was perfectly happy about Mrs Hound but I let slip that I had treatment from an osteopath for sciatica last autumn: "If we have to bring you back bent double in an air-ambulance, you won't be covered - you might be able to get full cover via a specialist broker". "I think I'll take the chance".

Having read this thread, I'm concerned that when Mrs Hound has her fancy new digital camera stolen, the company will refuse to pay out because "sciatica" was not on the form we completed. What do the experts on MSE think?

Harry.


"Sciatica" : a debilitating pain manifesting in the leg (ankle in my case) because the big nerve that runs down, caged within the vertebra of the backbone, is rubbing against a disc/bony nodule and getting inflamed.

If she was claiming for that particular condition, it would be declined. But a claim against baggage or theft of a personal possesion? The medical condition wouldn't be an element of that equation, so she shouldn't be declined on that grounds. It would be anything directly (or in some cases indirectly) linked to the medical condition that would be excluded.

Judith_Proctor

I had a very good experience with the Woolwich when a boiler had a massive escape of steam. The boiler itself wasn't claimable on the policy, but the damage from it was.

My primary memory is of a really helpful man on the end of the phone who was gentle and reassuring when I was panicky and distressed by what had happened.

Not only was that a good start, but they re-papered the entire hall and landing (the paper at the top of the landing had been damaged by the steam, but the paper needed to match all the way down). They noticed some damage to the ceiling, checked for asbestos, set up a complicated air-lock, safely removed the asbestos from the damaged ceiling and replaced the artex.

In short, they checked to see that the damage was as reported, but made no quibbles about fixing it and got their own people in to do the work and I was happy with the standard of work they did.

The rate has gone up this year (because I made a claim) but I'm more than happy to stay with them because of the quality of the service.

schoolfundraiser

As I am about to take out life insurance to cover my daughter should anything happen to me how detailed do they want your medical history - I am 52 this year and to be frank I can't remember exactly when I had what illness I know I had viral pneumonia in the same year as all the Legionnaires cases in the 70s which has left a shadow on my lung but I don't think they would accept as vague as that that. I can remember all the birth and pregnancy stuff but that is relatively recent. I assume they are interested in such as hospital stays and out-patient treatments - how do I get to find out the relevant dates etc so I can disclose it all on the form? It is mostly so long ago that the oriiginal medical records will have been archived and microfilmed long ago and I can't even the remember the address of the house I lived in then so finding them will be even more difficult given that the address and dob are the secondary markers for finding medical case note numbers.

SKS_3

My bathroom ceiling fell in, and I wonder if it is normal to get money towards having it fixed? It seems to have happened because of water leaking in from somewhere on the outside, but as it's top floor of the building, I am not able to check. The building is old and is just now being repointed etc. No idea when it was last done, as I've only owned the flat for two years.

There is more water damage on other walls/ceilings in my flat - can the insurers say it's wear and tear and refuse to pay?

They are making it so difficult to claim, and I find the whole thing such an uphill struggle!

S.

dunstonh

I am 52 this year and to be frank I can't remember exactly when I had what illness I know I had viral pneumonia in the same year as all the Legionnaires cases in the 70s which has left a shadow on my lung but I don't think they would accept as vague as that that.

Yes they do.

how do I get to find out the relevant dates etc so I can disclose it all on the form?

You dont need to. You disclose the illness and the rough dates and let the insurer decide how they will view it.

Remember to write the policy in trust to your daughter do there isnt a 40% IHT bill to pay on the sum assured if you do pass away during the policy term.

Scruff_2

Don't bother with travel insurance myself. Take the health passport when I'm in the EEC. If you lose anything it should be covered under your house insurance and if you need something medical - more than likely it won't be covered under your "Travel Insurance" if you've bought one - so why bother? I've had experience with different people over the years where they've taken ill abroad and the insurance company have not paid up for one reason or another so what's the point?

All insurance companies will try and wriggle out of a claim if they can. Car insurance is compulsory but all other insurance is optional in my book. The biggest con of all is travel insurance. People think they MUST have it - then don't. An amusing tale if ever there was one was a couple of years ago my old dad tried to get travel insurance to go for a week to Majorca. He's over 70, has asthma, angina and many years ago was successfully treated for prostate cancer. He eventually got a company to quote a price for the weeks travel insurance - £1,800. The actual holiday was only £150. Ridiculous. He went on the EEC card for nothing and had a great time.

Denzelpuppy

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.

You might be batting on a sticky wicket as to the value of the vehicle as Insurance comapnies do not use Ebay or Ad mag to value vehicles but have a monthly database as to car values which basically falls into what they could buy it trade for not what it could be bought for

harryhound

I once owned a car and someone rammed into the back of it.

As it was about 10 years old I was reasonably happy to get 1,200 for the accident out of the rammers insurance company as a "write off".

I still owned the car and managed to get it patched up and a year later sold it for relative peanuts to a "young blood" who hammered it for a year until something "went" in the steering.

So everyone was relatively happy.

HOWEVER I have heard the term A B & C cars mentioned in the second hand car jungle; this is something to do with protecting the insurance companies from paying out twice on the same vehicle.

Can someone explain how this works ?

Harry.

Correction: There are A, B, C, & D cars, where A is the most badly damaged & D the least.
My daughter used to drive a "Q" car. It was said to have been owned by a service man in Germany?? (My thanks to mattymoo)