In dispute with insurers for 3 yrs

Shoutingout

My husband and I have been involved for the last 3 years in, what should have been, a simple insurance claim following the devastating destruction of our home and most of our belongings to flood. Now in year three of our battle to get the substandard work of the repairs carried out by the Insurers contractor fixed, I wondered if anybody else has had similar challenges getting the Insurers to keep the promises made when the policy was taken out. The contractor was vetted by the Insurers, and recommended by contract administrator appointed by the Insurers.

Among our list of experiences are that we were not adequately informed by the Insurers, and part of our policy cover was invalidated as a result. We were only told after we had packed our own belongings that as we didn't get them professionally packed we were not insured for all the subsequent damage to them by the removal company.

Also we were told to obtain quotes ourselves from local traders to fix substandard repairs which were then rejected, without any reason given other than they were too expensive. The cash settlement offered to us would not cover the cost of the remedial work, so we have rejected it.

Most unbelievably, after we made a Freedom of Information request I was supplied with internal emails where we were ridiculed and judged over the items claimed. Nobody faithfully pays their premiums for years to be intentionally left “out of pocket” and facing a great deal of aggravation when the worst happens.

We have lodged a complaint with the FOS. They are unable to to deal with non-compliance issues, and the FCA are unable to get involved in individual cases due to Data Protection Act.

Do we have a case of "negligence", "poor duty of care" or "breach of contract"? Or maybe a combination? Should the Insurers be taking the lead with the repairs without us being involved? Should we be expected to fork out the shortfall and have the liability transferred onto us?

Any advice you could give would be greatly appreciated.

Many thanks and apologies for the lengthy email.

dacouch

Need a lot more info to give proper advice.

What exactly is the complaint to FOS about?

Why are you complaining about "Non compliance"

Personally I would expect the Insurer to cover reasonable damage to your contents whilst being moved out of your property due to an insured claim and / or as a result of the Insurers subcontractors.

Could you maybe give a time line of events and just generally more info

InsideInsurance

FOI is for non-personal information requests from public/ governmental organisations. As an insurer isnt a public body and you are talking about a personal case then this wasnt an FOI. Are you confused with a Data Protection Act Subject Access Request?

Why were the FOS unable to help? Were you outside of their 6 month time limit?

FCA involvement is nothing to do with the DPA but their remit. They are a governing body that look at the bigger picture of how financial institutes are run. The FOS' remit is to look at individual issues, it can pass up the line to the FCA anything that it sees as a trend developing rather than it being one off cases

magpiecottage

InsideInsurance wrote: »

The FOS' remit is to look at individual issues, it can pass up the line to the FCA anything that it sees as a trend developing rather than it being one off cases

More specifically, compliance issues are outside its specific terms of reference.

It will consider whether rules have been complied with as part of its assessment of whether somebody has acted fairly and reasonably but its purpose is to consider whether a customer has suffered as a result of a fault on the part of a financial institution and, if so, order that business to make redress. If the customer has not lost out then it cannot make an award purely to punish the business.

However, I agree with dacouch. If the insurer's contractors (who will be their agent) have damaged your property then you should complain to the insurer that they have damaged it and, since they are the insurer's agent, you expect the insurer to put it right.

InsideInsurance

magpiecottage wrote: »

its purpose is to consider whether a customer has suffered as a result of a fault on the part of a financial institution and, if so, order that business to make redress. If the customer has not lost out then it cannot make an award purely to punish the business.

Presumably as the OP has been fighting it for 3 years they do believe they have lost out and not simply looking for fines/ punitive damages to be levied against the insurer.

Shoutingout

Hi


Many thanks for your note.


The complaint to the FOS is about the cash settlement offered by the Insurers to deal with the remedial work of the substandard repairs carried out by the contractor vetted and recommended by the Insurers.


After a year in rented accommodation we moved back in. We weren't entirely happy as the work had not been completed. The house was habitable but one room remained unfitted. We were left to supervise the remainder of the work so we had to time off work for this. The contractor came a few weeks later to deal with the snagging issues. These were not resolved in their entirety. I can only guess due to the contractor's lack of organisation and/or communication with their team.


It was a year before the contractor came back to deal with the remainder of the approved snagging items, but again they didn't deal with all the snagging issues that had previously been agreed. We complaint to the Insurers that the contractor didn't seem to be very organised, and that we were put through a lot of hassle taking time off, chasing things around, etc and the issues still remained unresolved. In the interim some materials got discontinued, which would increase the cost of the repairs.


An independent surveyor was appointed to determine the quality and quantity of snagging items. He agreed that most of the snagging items brought to his attention needed to be repaired as the standard of workmanship was poor. The Insurers asked us to obtain quotes from local tradesmen as they knew that we weren't happy with their contractor. We were advised by the Insurers that they would offer us a cash settlement based on the quotes obtained by us to do as we pleased. When we put them forward to the Insurers they deemed them too expensive and offered us what they thought the cost should be. There was no supporting documentation to justify that their allowance would be sufficient to cover the cost of the substandard work. Some of the issues that we have been left with would involve retiling, re-flooring, re-plastering, redecorating, removing and refitting bedroom furniture, etc. Due to the length of time lapsed some of the materials have now been discontinued, which would make the rectification process even more expensive.


The Insurers have not offered to appoint a different contractor and resolve the issues for us. Ideally we would like to be provided enough funds, in accordance with the quotes obtained, to deal with the repairs ourselves without incurring a financial loss. The downside is that we would be taking on the risk in exchange for breaking away from the Insurers.


The other option is that Insurers do all the work, and keep the financial risk and liabilities associated with the repairs. We are far too familiar with all the hassle involved in having work poorly done. However, this option has not been presented to us. Are the Insurers technically breaching the contract by not offering us this option? We have the impression that the Insurers would be happy for us to deal with the repairs and front the cost, and then recoup the money from them. But this is obviously not attractive to us as we would be contractually bound to the tradesmen. Also we have no guarantees that the Insurers won't challenge the invoices and refuse to pay some. Not to mention the hassle for us arguing with the relevant parties if there are further problems with quality of the repairs.


By non-compliance I mean that the Insurers have not treated us fairly as customers, have not dealt with our claim and complaints in a timely and fair manner, have taken their team's side and dismissed many of our complaints as subjective without either looking into our extensive evidence, or challenging the quality of the services provided by their team, etc. The product sold to us has failed to do what it says on the tin, and we have been caused nothing but a great deal of aggravation and an exorbitant amount of time spent on dealing with the claim/complaints. We believe that the duty of care towards us as customers hasn't been exercised, and the focus has been on minimising the claim loss rather than ensuring that our claim was dealt with quickly and that as little hassle as possible was caused to us.


We have already provided the FCA with lots of evidence to raise awareness about all the barriers we've faced. It has been escalated to the relevant team. However, due to data protection act we won't know how the FCA has used the information provided by us, or the outcome.

Do you need any further details? If so, please let me know.

magpiecottage

No rules broken, from what you say - and not something FOS or the FCA would become involved in.

If you think you have not been treated fairly then complain.

If you do not like the response then go to FOS.

Shoutingout

Hi


The FOS was unable to help with the non-compliance issues that we raised. We provided them with copies of internal correspondence with unprofessional remarks but they couldn't comment on these, on how the Insurers team communicated, whether inaccurate information had been provided, or whether the Insurers team were influencing them or colouring the Insurers perception on us.


Sorry, we got a subject access request. We discovered that there have been misrepresentations on some reports: for example according to one report the policyholders rejected samples of bathroom tiles provided by the contractor, and insisted on using their own supplier. The contractor never showed anything. Also, we have discovered that there were changes to the agreed schedule of works without us being consulted by the contractor administrator appointed by the Insurers. Instructions were issued to the contractor without us being informed prior to the changes being instructed. As the customers and house owners, shouldn't we have been informed and consulted? As we didn't sign off the cheques it seem that we didn't count for much. Finally, it has transpired that in paper we have been portrayed as customers with unreasonable expectations.

Shoutingout

Hi


We have not incurred a financial loss as of yet because we have not carried out the necessary repairs, which would involve us moving out of the house temporarily. We don't have the kind of money necessary to carry out the repairs and taking a loan, on top of our current mortgage, is not an option.


However, we have incurred other additional costs indirectly associated with this claim. The FOS have advised us that they can only ask for reimbursement of a financial loss directly linked with the terms and conditions of the policy. The FOS understand that we've incurred other costs, but they have advised us that they would fall under the "punitive" category and they can't enforce this as they are not regulators.


What I'm very surprised about is that the FOS haven't commented on whether we have been treated fairly or unfairly during the claim and complaint process despite the volume of significant evidence presented to them. I would have thought that they would have provided some feedback on this.

Shoutingout

We have lost out a huge amount of time and energy in the process. We have been put through a lot of stress and inconvenience, which has had an impact on our health. Rather than making life easier for us at such a difficult time we feel that the Insurers have made the journey unnecessarily difficult and painstaking for us.


The whole episode is extremely frustrating, and we'll never get any of the time back not to mention our well-being.


It's clear throughout the process that unless we shout out, nothing gets done...


Can somebody help with some useful tips / feedback from personal experience? I'm not sure if we have a case of negligence, breach of code of conduct, breach of contract, conflict of interest, or a combination...?


Many thanks for your help

Shoutingout

What do you mean that no FCA rules have been broken?


We have already complained about unfair treatment to the Insurers, but no use. The FOS can't comment on unfair treatment as they are not the regulators. And the FCA can't comment due to data protection act.


So all the avenues we have explored have not provided a solution.