In dispute with insurers for 3 yrs

Shoutingout

Good question RS65

Because we want to do some homework now so that we can make an informed decision when the Ombudsman issues their financial decision letter as you have little time to make a decision to accept or reject the FOS ruling.

As we've identified various other issues we thought that maybe we also have a case of breach of contract, conflict of interest and negligence but I appreciate that we'll need to just go-ahead and spend £2,000 to find out if we have a case. I'm not really sure if it's worth it. I've been advised that we can pay a direct access barrister to get an initial opinion of our chances without having to go to a solicitor.

The most frustrating thing for us is how the regulators are not really being of any help. We were left speechless when we presented so much evidence to the FOS that they just wouldn't comment on.

If the FCA don't get involved with private customers like us and don't guarantee that they'll investigate how insurers deal with cases like ours, and if the FOS don't deal with non-compliance issues, WHO can protect and assist customers in a situation like ours? Any thoughts? I know this might sound catastrophic and dramatic, but this is our personal experience.

rs65

Shoutingout wrote: »

The most frustrating thing for us is how the regulators are not really being of any help. We were left speechless when we presented so much evidence to the FOS that they just wouldn't comment on.

If the FCA don't get involved with private customers like us and don't guarantee that they'll investigate how insurers deal with cases like ours, and if the FOS don't deal with non-compliance issues, WHO can protect and assist customers in a situation like ours? Any thoughts?

You need to understand the roles here. FOS are not regulators. Their job is to settle disputes between financial services firms and their customers. You can present reams of 'evidence' to them but if it isn't relevant to your specific complaint, it doesn't matter.

The FCA is the financial services regulator. They won't get involved in individual complaints but if your issues contribute to demonstrating systemic issues, they may take action. You won't necessarily be kept informed but advising them may be useful to others.

I'm sure your knowledge of the FOS procedures will mean you are aware you always have the option to take a matter to court.

Presumably any court action would be simply for breach of contract - rather than negligence or conflict of interest. My simple understanding of the legal process is that breach of contract is much easier to pursue than claims in negligence. I don't know why you mention conflict of interest but await your book with interest.

Shoutingout

Yes, Ive learnt a lot in the proce. We've gathered so much evidence over the course of 3 years that it's mind blowing - just to give you an idea we've got the equivalent of 10 yellow pages of paperwork sitting in the study after receiving the subject access request on our personal data, and 4 large lever arch files files.

The conflict of interest is because we believe that the Loss Adjustor firm have not dealt with our claim in an impartial and objective manner as per the CILA code of conduct. I guess that the more the loss adjustor saves the insurers on claims the more work they'll get. This is why we'd recommended anyone going through a large claim to pay for their own loss adjustor. I knew nothing about claims and about our rights and options before we were flooded. We would have done things very differently now.

Because we want to raise awareness and helped others we've provided the most relevant evidence to the FCA.

rs65

Shoutingout wrote: »

I guess that the more the loss adjustor saves the insurers on claims the more work they'll get.

Not really. Take your circumstances for example. The insurer would rather a claim is settled efficiently, economically and fairly. The last thing they want is the three years of grief that you (and they) are going through.

Shoutingout

Trust me - I entirely see where you're coming from. If the Insurers had dealt with our claim efficiently, promptly and fairly the Insurers would have saved themselves money and not wasted our time, and their resources.

Ultimately the Insurers trust the assessment made by their appointed loss adjustor, without, understandably, expecting to challenge their advices. The loss adjustor took weeks before agreeing to budgets. He kept rejecting our claims without any explanation or reference to the terms and conditions of our policy.

As for their ancillary surveying services their contract administrator didn't do a very good job in supervising the work otherwise we wouldn't have been left in such a mess. If I was the Insurers I would want to know why the surveyor didn't pick up on the various issues we raised, and also signed off substandard work as entirely acceptable. My brother in law is an architect and he was appalled by the poor coordination and lack of supervision, etc. We voiced our concerns and complaint to the loss adjustor firm about their services. We were never given the name of a claim handler so as far as we were concerned the loss adjustor was the Insurers rep.

Personally if I was the Insurers I wouldn't be entirely happy with the loss adjustor firm. In my opinion, they've let both, the insurers and the insured, down.

Initially we gave the Insurers the benefit of the doubt as we belived that ultimately the Insurers were acting on a third party's professional advice, and it wasn't really their fault. However, we changed our opinion after reviewing the subject access request and seeing the unprofessional remarks. They ridiculed us for not wanting to be out of pocket with our claims. Their complaint process was appalling and they proved to act irresponsibly towards us as their customers. No matter how much evidence we sent them , they would just dismiss our complaints as subjective or give us transparent excuses. It was obvious that they hadn't been diligent in their investigation nor challenged their consultants.

I guess the Insurers won't be admitting any form of liability voluntarily unless they're made to by the FOS, FCA, bad publicity or court. Thankfully, despite being portrayed as being unreasonable in our expectations the expert witness surveyor has ruled in our favour.

We hope that other Insurers treat their customers fairly and take full ownership when things go wrong. Unfortunately we haven't been very lucky with the people involved in our claim, from the loss adjustor to the contractor, claim handler and contract surveyor.

Shoutingout

Hello

We've decided to seek legal advice and also get in touch with a loss assessor to assist us with our case, as battling on our own is proving extremely difficult!

Many thanks for your help