Gradual operating causes.

Sagwala

Had Ins. surveyor round today for conservatory claim ref. Storm damage. He agreed the damage and due to our exposed position agreed the weather played its part.

However he explained that he would have to decline the claim on the basis that it was not one specific storm or event on a given day that had caused the damage but 'gradual operating causes'

He was extremely polite, professional and gave me loads of info on how to pursue the claim to get it looked at again, and if not possible to get a 100% claim then maybe a commercial decision based upon the insurer contributing an amount.

He said to get a catalogue of evidence, ie the fact of our house position being very exposed etc etc and also two quotes detailing fully the remedial works and propose this to the insurer.

Obviously I intend to do this, but would appreciate any advice going forward of someone who has maybe experienced a similar situation with regard to successfully claiming or getting part settlement for 'gradual operating causes'

Thankyou in advance.

agrinnall

Have a read of this, I'd never heard of it but I think you may struggle to win this one.

http://www.financial-ombudsman.org.uk/publications/technical_notes/storm-damage.html

bbk87

sagwala wrote: »

Had Ins. surveyor round today for conservatory claim ref. Storm damage. He agreed the damage and due to our exposed position agreed the weather played its part.

However he explained that he would have to decline the claim on the basis that it was not one specific storm or event on a given day that had caused the damage but 'gradual operating causes'

He was extremely polite, professional and gave me loads of info on how to pursue the claim to get it looked at again, and if not possible to get a 100% claim then maybe a commercial decision based upon the insurer contributing an amount.

He said to get a catalogue of evidence, ie the fact of our house position being very exposed etc etc and also two quotes detailing fully the remedial works and propose this to the insurer.

Obviously I intend to do this, but would appreciate any advice going forward of someone who has maybe experienced a similar situation with regard to successfully claiming or getting part settlement for 'gradual operating causes'

Thankyou in advance.

Gradual operating cause is something that is expressly excluded within your policy. It will say it in the policy booklet under 'Uninsurable risks' which will be under general exclusions to the whole policy.

This just means that the weather, over a period of time, has caused this damage to your roof, not one 'single' event.

If you have Accidental Damage on your policy, any internal damage to ceiling, walls etc can be covered under that.

Sagwala

I do understand all of this, however my point of argument is this ....

The point at which any movement became noticeable to us was after a weekend of strong winds. When on the morning in question a 2" gap could clearly be seen between the wall and the conservatory. Prior to this, nothing was apparent.

This particular sudden shift in the conservatory structure was due to a one off event of strong winds over the course of the weekend storms.

For example if my chimney had blown off and crashed to the floor in the same winds, how would it be possible to state or prove that this was due to operating causes. One storm event, one sudden shift, one catastrophic outcome.

My logic would apply the same principle in this case.

I am no structural surveyor or indeed in the habit of regularly getting my conservatory checked for its structural soundness. Like anybody, you presume that these structures are erected professionally and are structurally sound to withstand reasonable forces.

The principle of 'gradually operating causes' seems to rely on the policyholder noticing the very first initial shift in structural soundness, which could have been caused by a storm some time ago, and at that point submitting a claim. Obviously any 'first shift' cannot be classified as gradual.

I am up for this fight and will keep the progress posted.

However, would be most grateful of any agreement or discrepancy in my thought process as other points of thought or experience is always welcome.

David_InsDef

Its quite difficult to comment without knowing the nature / extent of the damage. Is the damage consistent with what you would typically see resulting from a storm?

It sounds as though he's saying that the conservatory has deteriorated over time (maintenance issue or not constructed correctly in the first place) and the damage has presented itself or been exacerbated by a storm event? In which case, the storm isn't the underlying 'cause' of the problem.

That said, remember, he's a loss adjuster and it's his job to minimise or bat away claims.....

What's the cost to repair or reinstate it?

David_InsDef

If it helps, the Ombudsman uses the 'but for' test to evaluate this kind of thing - i.e. 'but for' the storm, would the damage that you can see still have occurred? If the answer is yes, it just would have taken longer to present, then your claim should fail. If the answer is no - then there's a chance you have a valid claim.

eddddy

Hi sagwala

The insurance co has instructed their 'expert' to give an opinion. (Not surprisingly, he will protect the insurance co's interests.)

If you disagree with their 'expert', you can instruct your own 'expert' to give an opinion.

As it stands, it's your opinion vs a surveyor's opinion. I assume you are a layman. So the insurance co, ombudsman and/or court will give more weight to the surveyor's opinion than yours.

Getting a report from your own surveyor will balance things.

Sagwala

David_InsDef wrote: »

If it helps, the Ombudsman uses the 'but for' test to evaluate this kind of thing - i.e. 'but for' the storm, would the damage that you can see still have occurred? If the answer is yes, it just would have taken longer to present, then your claim should fail. If the answer is no - then there's a chance you have a valid claim.

Hi David, I have had two companies out to survey and quote, although that was only on Friday,so expecting their quotes this week. We have got to be talking upwards of 5k, because they have got to totally deglaze the entire conservatory including the roofpanels, realign and make good. Given it is an 11mtr structure that aint no mean feat!!

The insurance surveyor himself was under no illusion of the task at hand, suggesting multiple thousands rather than hundreds.

As a professionally installed conservatory that is only seven years old, maintained and showing no signs of delapidation, I can only conclude that 'but for' the storm damage the structural integrity would be sound.

I am going to go for a 100% claim, obviously, but would also be open to a 'commercial decision' based upon the grey mitigating circumstances of operational causes.

Sagwala

eddddy wrote: »

Hi sagwala

The insurance co has instructed their 'expert' to give an opinion. (Not surprisingly, he will protect the insurance co's interests.)

If you disagree with their 'expert', you can instruct your own 'expert' to give an opinion.

As it stands, it's your opinion vs a surveyor's opinion. I assume you are a layman. So the insurance co, ombudsman and/or court will give more weight to the surveyor's opinion than yours.

Getting a report from your own surveyor will balance things.

Edddy,

Thankyou for taking the time to post.

I too had given that some consideration and maybe, depending on how negotiations progress, I will do this.

Although, referring to my OP and subsequent comments, I don't think any surveyor would be able to categorically say that it did or did not occur under the circumstancesof one singular event.

And, how do you measure progreessive damage,when you have no indication it is happening? My only indication of the damage was when it was quite clear after the weekend winds that there had being a fairly substantial structural shift, which presented itself with a 2" gap between the wall and the conservatory. Had this have been 'gradual' it is quite clearly something we would have spotted and reported on before now.

eddddy

sagwala wrote: »

Edddy,
..
Although, referring to my OP and subsequent comments, I don't think any surveyor would be able to categorically say that it did or did not occur under the circumstancesof one singular event.
...

If you're correct, then that's great...

... you get another surveyor to say that the insurance co surveyor cannot possibly know whether it was 'gradual operating causes' or a single event.

(Again... you are expressing your opinion, and the opinion of other posters. You need a professional surveyor to say it.)

David_InsDef

sagwala wrote: »

Hi David, I have had two companies out to survey and quote, although that was only on Friday,so expecting their quotes this week. We have got to be talking upwards of 5k, because they have got to totally deglaze the entire conservatory including the roofpanels, realign and make good. Given it is an 11mtr structure that aint no mean feat!!

The insurance surveyor himself was under no illusion of the task at hand, suggesting multiple thousands rather than hundreds.

As a professionally installed conservatory that is only seven years old, maintained and showing no signs of delapidation, I can only conclude that 'but for' the storm damage the structural integrity would be sound.

I am going to go for a 100% claim, obviously, but would also be open to a 'commercial decision' based upon the grey mitigating circumstances of operational causes.

Hi,

The key issue you have is that whilst in all likelihood it's true, the fact that you had a professionaly installed conservatory isn't in itself, evidence that something that is covered by your insurance policy (an insured event) has happened to cause it to become damaged. The onus is on you to prove that you have a valid claim, more so than it is on your insurers to demonstrate that you do not.

Your policy covers you for very specific events (perils) and anything outside of these is simply not covered. In what way do you believe the storm has damaged the conservatory? I'm only asking in this way as you'll be expected to articulate, pretty convincingly, either to the insurer or the Ombudsman that the damage is consistent with what you would expect a storm to produce - and as eddddy says, ideally backed up with some form of informed or expert evidence.