Can Loss Adjuster overturn Police Evidence?

GazMc64_2

Can anyone tell me if it is usual for a loss adjuster to ignore police forensic evidence and make his own recommmendations to my insurance company? I was a victim of a burglary back in April this year and unfortunately the PC who attended the scene submitted an incorrect and incomplete report, the insurance company sent an obnoxious loss adjuster to my home and subsequently they rejected my claim. I appealed to both the insurance company and to Merseyside police and the police, who have been fantastic in their support, amended the report to include the CSI evidence that the doors had been forced to gain entry, but despite the police having a telephone conversation with the loss adjuster on the subject, and the loss adjuster receiving a copy of the amended report he is insisting that he will still be recommending to the insurance company that my appeal be rejected on the basis that he thinks the doors were not forced. I am at my wits end with this, I had to replace all locks and repair patio doors, the thieves took my car and house keys, wallet etc, and despite being caught on CCTV trying to use my credit cards they have walked free from court. I feel like the criminal here because I am refusing to let this go and to cap it all a lot of other insurance companies will not quote for my renewal because I have 1 claim on my records (1 claim in over 10 years I might add)

eddddy

Hi GazMc

Essentially, you've made a claim and the insurance company have rejected it.

So you need to follow the standard complaints procedure: Write a formal letter of complaint to the insurance company. (Although you say that you "appealed" to the insurance company, so perhaps you are already in the formal complaint process.)

If it's still not resolved to your satisfaction, you can go to the Financial Ombudsman Service.


It sounds like the argument hinges around whether forced entry was used - so you should concentrate on gathering strong evidence on that specific point (including the police report).

InsideInsurance

Ultimately you have two moderately trained experts with differing opinions, it certainly wont have helped your case at all that the police initially gave the wrong report.

The other problem is that police will often dont bother doing the most investigation into these types of crimes and can be fairly flexible in what they write in reports. I had a spate of break-ins to by old car and the first time the CSI came out and looked and immediately said there was no point dusting for prints as there'd be hundreds of partials and due to the texture of the inside of the car all would be too degraded to get a match. He didnt bother dusting but his report said there were partial prints.

Second time it happened, he phoned me instead of attending and said he'd put the same in the report again without even visiting. Third time I didnt even get to speak to him or a policeman as the call handler asked if I wanted a visit or could they just give me a crime reference number and the standard report based on the phone call.

Unfortunately insurers now this and so report changed at policyholders request to now support their claim doesnt stack up well for them.

The FOS are not the most experienced people in the world on the other hand and you'll probably have a reasonable chance with them. As you've had your response from your complaint already then escalate it to them

GazMc64_2

eddddy wrote: »

Hi GazMc

Essentially, you've made a claim and the insurance company have rejected it.

So you need to follow the standard complaints procedure: Write a formal letter of complaint to the insurance company. (Although you say that you "appealed" to the insurance company, so perhaps you are already in the formal complaint process.)

If it's still not resolved to your satisfaction, you can go to the Financial Ombudsman Service.


It sounds like the argument hinges around whether forced entry was used - so you should concentrate on gathering strong evidence on that specific point (including the police report).

Hi Eddddy, I am going through a formal appeals process but find it difficult to accept that the loss adjuster can tell the police verbally that their evidence will not make any difference to his decision, he has made up his mind that the door was undamaged and that is that! When the loss adjuster visited us almost a week after the burglary he arrived in a foul mood and obviously this has had a bearing on his decision. I am past caring now but I just wanted to vent my frustrations!! cheers

GazMc64_2

InsideInsurance wrote: »

Ultimately you have two moderately trained experts with differing opinions, it certainly wont have helped your case at all that the police initially gave the wrong report.

The other problem is that police will often dont bother doing the most investigation into these types of crimes and can be fairly flexible in what they write in reports. I had a spate of break-ins to by old car and the first time the CSI came out and looked and immediately said there was no point dusting for prints as there'd be hundreds of partials and due to the texture of the inside of the car all would be too degraded to get a match. He didnt bother dusting but his report said there were partial prints.

Second time it happened, he phoned me instead of attending and said he'd put the same in the report again without even visiting. Third time I didnt even get to speak to him or a policeman as the call handler asked if I wanted a visit or could they just give me a crime reference number and the standard report based on the phone call.

Unfortunately insurers now this and so report changed at policyholders request to now support their claim doesnt stack up well for them.

The FOS are not the most experienced people in the world on the other hand and you'll probably have a reasonable chance with them. As you've had your response from your complaint already then escalate it to them

Thanks, i agree with you on many points but give the CSi their due, on this occasion most of my house, inside and out, was covered in fingerprint powder by the time they left and when they found my car it looked like it was caught in the volcanic ash cloud. Having said that unfortunately they did not get a single print!

FlameCloud

Do you actually have a forcible and violent entry clause within your policy, or is it a warranty?

Also, what type of door and locks are we talking about.

Spikey1

Hi GazMc,


On the basis that the dispute is as simple as you describe it in your post.......then the answer to your question is 'No' a Loss Adjuster's opinion will not stand as stronger evidence than the opinion of the investigating police officer.


If this goes to the Insurers complaints dept they will overturn the Adjusters decision......if the situation is as simple as you have put it.


However, my instincts are telling me that there must be more to the story.......is there anything else you could share with the forum which might allow us to assist you further ?


Cheers

Parking_Trouble

If you have the amended CSI report that clearly says there was forced entry then I would remain optimistic that (if it gets that far) the FOS would overturn the insurers decison.

A CSI report is surely of a standard that could be used in court and recognised as expert evidence.

Surely that trumps a loss adjusters report which could be perceived by some as looking for any excuse to reduuce the payout?

TSx

Parking_Trouble wrote: »

If you have the amended CSI report that clearly says there was forced entry then I would remain optimistic that (if it gets that far) the FOS would overturn the insurers decison.

A CSI report is surely of a standard that could be used in court and recognised as expert evidence.

Surely that trumps a loss adjusters report which could be perceived by some as looking for any excuse to reduuce the payout?

Based on the original post, it does seem very unfair.

I have come across this before though - a claim I remember very clearly where there was a break in with no forced entry whilst the policyholder was out. There was a security endorsement active on the policy so we made a decision to repudiate the claim

The policyholder submitted various evidence including a lengthy letter from the investigating officer which confirmed the lock had been 'slipped' which had allowed entry, although confirmed there were no signs of forced entry. The letter from the police said they believed we should pay the claim.

We maintained our repudiation after taking advice from the supplier who dealt with locks at the time, essentially saying that what the police were suggesting was impossible.

Unfortunately, the police aren't always technical experts - on a side note, we've all but had to abandon the usual requirement for forced entry into an unattended vehicle because the police now seem to say as standard that it was probably a 'special device' used to unlock the car, rather than risk suggesting it was the more likely act of the car being left unlocked.

GazMc64_2

Spikey1 wrote: »

Hi GazMc,


On the basis that the dispute is as simple as you describe it in your post.......then the answer to your question is 'No' a Loss Adjuster's opinion will not stand as stronger evidence than the opinion of the investigating police officer.


If this goes to the Insurers complaints dept they will overturn the Adjusters decision......if the situation is as simple as you have put it.


However, my instincts are telling me that there must be more to the story.......is there anything else you could share with the forum which might allow us to assist you further ?


Cheers

I can only add that by the time the loss adjuster appeared I had replaced the locks and repaired the door, all the doors are upvc with multi locking points operated by the handle, the CSI told me that the likelyhood is the thief used a 'bump'key, to break the lock and gain entry, they don't need to smash their way in. When the locksmith was replacing the door locks he showed me what they meant, he needed to replace the locks because they took the keys and he was in in seconds

22johnny22

What evidence was there that there was forcible entry? I would suggest getting something in writing from the locksmith.

You say they broke the lock, have you still got it? Any photos?

any evidence you have to show there was forcible entry would be of use to you and the police having a report confirming the position even though changed will stand you in good stead.