ESure building and contents. Refuse to pay

Spinflight

Hello,

As a first time buyer I didn't go for a cheap policy as with three young children I couldn't afford for anything drastic to go wrong.

We had only been in our house for 6 months when the kitchen ceiling fell in due to a crack in the cistern directly upstairs.

It was quite a substantial leak which emanated from the crack in the back of the cistern, running down the white tiled wall and then pooling under the floorboards until the ceiling gave way.

Esure seemed reasonable at first, when I asked to hurry things along ( the bathroom was extensively damaged and we were resorting to bathing the kids in the kitchen sink) they offered to send a surveyor out.

Out he came whilst I was at work and then rang to say that he was denying our claim because the missus had told him it had been leaking since Christmas!

As we hadn't even moved into the property until way after christmas this was a bit puzzling to say the least.

Hence I asked to see a copy of his report which he agreed to but said he would have to amend it as I had disputed some of his findings... Particularly the bit about my missus telling him it had been leaking for months ( given the size of the leak we would have needed a lifeboat instead of a plumber if it had leaked for that long).

Naturally he didn't send the report however I contacted his manager who did forward me a copy of what he claimed the report was, which was just a series of photographs ( not even relevant ones unless the washing basket caused the leak) however refused to say what the 'surveyor's' professional qualifications or memberships were.. No text in it which might need amending.

Now I am in a situation where Esure say that the surveyor has refused the claim. My insurance however isn't with the surveyor and they won't give a reason other than that it was the surveyor's decision.

What should I do?!

InsideInsurance

Register a formal complaint, if you arent happy with their response or dont get a response within 8 weeks then take the matter to the FOS.

Spinflight

Is that a formal complaint with esure or with an outside body?

I rather regret asking them to speed things up due to our circumstances. It seemed to have the opposite effect to that intended.

Also what of the surveyor? Is it appropriate to make judgements on heresay even if there was an ounce of truth in them? Should I make a complaint to his professional body, assuming he is part of one?

Quentin

Follow esures complaints procedure which will be set out in your policy docs

InsideInsurance

Spinflight wrote: »

Is that a formal complaint with esure or with an outside body?

I rather regret asking them to speed things up due to our circumstances. It seemed to have the opposite effect to that intended.

Also what of the surveyor? Is it appropriate to make judgements on heresay even if there was an ounce of truth in them? Should I make a complaint to his professional body, assuming he is part of one?

Ignore the surveyor etc, your contract is with your insurers and its their processes you need to follow.

It is certainly appropriate to make judgements on things the customer tells you. Whilst I disagree that insurers intentionally look for ways to avoid payment of claims if through the process of discussing the incident with the insured they happen to let slip something that would invalidate the insurance or impact the claim then the insurer will not turn a blind eye to it.

The advantage of when this happens on the phone is that it is normally recorded so you can subsequently prove the customer said it was "during a business trip" rather than commuting on a SDPC car policy. The disadvantage with face to face meetings is that it becomes one persons word against the others and so ultimately hard to prove what was said if there is a later dispute.

Spinflight

Well after asking for a letter rejecting my claim so that I could go through the complaints process, something which we have never had, I had a call from Esure the other day saying that they had re-opened our case ( again) and were asking the surveyor some more questions...

They mentioned a second leak ( which the surveyor didn't find or mention) rather than anything the missus might have said.

It doesn't need saying but I trust her implicitly, and it isn't the sort of thing she would say to a stranger even if true!