Problem with Coveare Insurance ( Lloyds T.S.B )

bifter1

Hi this is my first post on here , hope someone can please advise me .We came home from 5 nights away at my mothers last week to find our garden shed had been broken into and my fishing equipment was stolen so I contacted my insurance company who arranged for a loss adjuster to visit yesterday , before she left she advised us that all was ok she just needed to check what the maximum amount covered on our policy was and get back to us , We had'nt heard back from her by lunchtime today so I got back to the insurance company who advised me that a stipulation had been added to the policy in 2012 that stated that a home security system must be installed and in use and serviced yearly from a registered company ,I was flabergasted to hear this as this was the first I have heard of this ,it was'nt on the policy when I first took it out in 2009 ,I checked my policy and on the documentation on page one question 3 is Do you have a burgler alarm fitted ? . and my reply is in black and white NO . I Checked the small print on this years and last years policy and the alarm issue was placed on there in 2012 due apparently to us living in an high risk area ,I am absolutely distraught as they are saying my insurance is invalid and has been since this stipulation was put on ,I feel that the company knowing I had no alarm should have written to me stating there new rules and offering me the choice of complying with it and installing an alarm or offer me a policy with this stipulation removed even if the costs rose or just said because I had no alarm fitted they wouldnt insure me ,I feel misslead and that I have been robbed twice ,I paid my policy month after month loyally ,while all the time the insurance company knew full well my policy was worthless ,I have contacted the!Ombudsman!and F.S.O who both think I have a good case ,I have also formally complained to both!coveare!and!Lloyds!tsb ,I am very worried and upset though so any help or guidance would be gratefully received ,Thanks Guys

rs65

bifter1 wrote: »

while all the time the insurance company knew full well my policy was worthless

They didn't know it was worthless. Just because you ticked 'no' in 2009 doesn't mean you don't have an alarm now.

Clearly you didn't read the changes in 2012.

I would regard that as a significant change and think it should have been addressed specifically. All policies can change year on year and changes made, but with this type of change I would have think they should have asked the question and then offered (or not offered) renewal.

I think it will come down to how obvious this change was in 2012.

Hopefully a complaint to the insurer will give you a result. If not, they will explain how to take it to the ombudsman.


ps As an angler, I feel your pain.

BartSimpson_2

The insurance company is called Covea just so you're aware.

This does seem unfair. If they are going to add stipulations to the policy then these should be clearly highlighted to you on renewal documentation. This is especially the case where they require that you take some action as in this instance.

I would simply ask to speak to their complaints department and state that you don't feel this is a fair decision to decline your claim. They will review your case and have 8 weeks to make their final decision.

If the final decision still isn't in your favour then you can take your case to the Financial Ombudsman (FOS). If they've already indicated that you have a strong case then it may be worth mentioning this to the insurance company as they will take a great deal of notice because it is never good to lose cases that go to the FOS as it shows that they're not making fair decisions.

TSx

What is the exact wording of the security condition? I'd be very surprised if it included the garden shed in it.

The FCA (the financial industry regulator) publish a handbook for companies, which sets out standards that must be met by insurance companies, called ICOBS.

ICOBS 8.1 has the following conditions:

An insurer must:
(1) handle claims promptly and fairly;
(2) provide reasonable guidance to help a policyholder make a claim and appropriate information on its progress;
(3) not unreasonably reject a claim (including by terminating or avoiding a policy); and
(4) settle claims promptly once settlement terms are agreed.

and

A rejection of a consumer policyholder's claim is unreasonable, except where there is evidence of fraud, if it is for:
(1) non-disclosure of a fact material to the risk which the policyholder could not reasonably be expected to have disclosed; or
(2) non-negligent misrepresentation of a fact material to the risk; or
(3) breach of warranty or condition unless the circumstances of the claim are connected to the breach and unless (for a pure protection contract):
(a) under a 'life of another' contract, the warranty relates to a statement of fact concerning the life to be assured and, if the statement had been made by the life to be assured under an 'own life' contract, the insurer could have rejected the claim under this rule; or
(b) the warranty is material to the risk and was drawn to the customer's attention before the conclusion of the contract.

Given that the property has not been broken into, if you had met the conditions of the warranty, it is unlikely that this claim would have been prevented.

Covea should not be rejecting a claim on these grounds.

I've dealt with plenty of claims where someone has a security condition requiring that they have certain locks on their windows - if someone smashes the window, and they don't have the right locks, we still have to pay the claim, because if the condition had been met it wouldn't have prevented the claim.

You need to follow through on your complaint, and take it to the FOS if neccesary. I'm fairly confident they will uphold your complaint, providing that you don't have an unusual wording on the security condition.

edit: there is also a potentially relevant existing FOS decision here which includes the quote

There is no argument that the endorsement is clearly detailed on the Policy Schedule and, strictly speaking it should be adhered to. However, RSA knows that this service considers a breach of an endorsement will only allow it to decline liability for a claim where that breach leads directly to the loss suffered. There is no evidence of that here. I also note that RSA has declined to respond on this point, clearly raised by the adjudicator on more than one occasion.

bifter1

Thanks everyone ,It does'nt mention sheds on my policy anywhere ,Even if I had an alarm fitted to my home it probably would'nt have extended to my shed which is about 30 feet from my home so think the insurance company is simply trying to avoid settling the claim ,We did think it strange that when she left , the loss adjuster announced that she would take a photograph of the front of our property which we found rather odd as the theft was from the rear of our property and as we live in a terraced house you cannot even access the back garden or see it from the front ,in hindsight she was probably just taking the photo to show that no alarm was fitted , I think this significant change in my policy should have been clearly explained in a letter to me and then left for us to decide to either have an alarm fitted and carry on with the policy or decline it and take our business elsewhere without this stipulation .I am deeply upset and concerned but after speaking to both the Ombudsman and fso and reading your replies I am quite hopeful of a good outcome ,Thanks once again I will keep you all informed of developments

TSx

bifter1 wrote: »

Thanks everyone ,It does'nt mention sheds on my policy anywhere ,Even if I had an alarm fitted to my home it probably would'nt have extended to my shed which is about 30 feet from my home so think the insurance company is simply trying to avoid settling the claim ,We did think it strange that when she left , the loss adjuster announced that she would take a photograph of the front of our property which we found rather odd as the theft was from the rear of our property and as we live in a terraced house you cannot even access the back garden or see it from the front ,in hindsight she was probably just taking the photo to show that no alarm was fitted , I think this significant change in my policy should have been clearly explained in a letter to me and then left for us to decide to either have an alarm fitted and carry on with the policy or decline it and take our business elsewhere without this stipulation .I am deeply upset and concerned but after speaking to both the Ombudsman and fso and reading your replies I am quite hopeful of a good outcome ,Thanks once again I will keep you all informed of developments

It's fairly standard practice to take a photo of the property from the front, certainly in the reports we receive from loss adjusters, so I wouldn't take anything from that specifically.

Vicmeldrew

They also report on the 'state' of your living accommodation after they have gone (sometimes taking pictures when you leave the room for a moment to fetch a document)

weejonnie

A lot may depend on how the change in policy conditions was implemented.

If all you received was the renewal notice and there was no pro-active attempt to advise you of the change then you should be OK on your claim.

If there was a note attached saying "Important Information" or "Changes to your policy" etc then the FOS may rule in the insurer's favour.

Verbal messages don't count. If it isn't written down it never happened.

I suspect that the problem may be more with the (lack of) systems and controls in place at Lloyds when issuing renewals rather than with Covea itself.