Insurance & matching sets exclusion

gazb84

Hi, my first post here. hope someone can help.


I'm anticipating a bit of a battle with my insurance company following an accidental damage claim affecting my kitchen. (burst pipe causing water damage) and I'm after some advice please.


In summary, the matching sets exclusion was notified to me at the outset of the claim, and whilst I appreciate it's intent, in my specific circumstances I don't think it's fair than I am penalised.


All of the units that are on the floor have had to be written off due to the water damage, there is also a larder unit that integrates the high level units with the bottom half. This larder unit has also been removed.


The critical point here I feel is that when the exclusion was discussed, it was suggested to me that the original doors could be retained and fitted to the new carcasses as the doors weren't damaged it was only the carcass as it was touching the floor directly. I was more than happy with this approach as it maintained the overall integrity of the kitchen and it's appearance.


Problem is that the insurer didn't communicate this to the contractor so now there are no matching doors available as the contractor disposed of the units and with the doors still attached.


Personally I don't feel that I should now be penalised for this miscommunication between the insurer and contractor and we are being asked to contribute 50% towards the replacement of the non damaged elements of the kitchen, which would not have needed to have been the case if the doors were kept.


We are not looking to get a new kitchen out of this, simply a matching kitchen, which is the same position as we were in before the loss, which I feel is wholly reasonable and the intention of an insurance policy in any case.


Interested to hear of anyone else's experience and whether you feel I have a justifiable argument.


Hopefully this makes sense but happy to clarify any points that aren't clear.

rich13348

Where were you when the contractor removed the units plus doors?

InsideInsurance

The FOS normally support the idea of a 50% contribution to non-damaged parts of sets.

You need to register a complaint that their contractors have failed to follow the agreed path which would have negated the need for either party to pay anything towards the upper units.

gazb84

We have not occupied the property since the loss occurred, due to us having no kitchen, living room carpets being damaged, and us also have a 10 week old new born and 3 year old. Bad timing to say the least. We have been living with inlaws since the 18th June and we received our 'dry certificate' on Friday so work should now commence with the re-fit.

gazb84

Although the contractor did carry out the work, part of the argument we are now having is that the loss adjuster did not make the contractor aware of our the discussion to retain the doors in the first place.

gazb84

I've answered your previous question on this thread, just wondered if you have an opinion on the issue at hand? cheers.

David_InsDef

Were the contractors appointed by the insurer or did you source / appoint them yourselves? Also, is there a Loss Adjuster involved?

martinsurrey

David_InsDef wrote: »

Were the contractors appointed by the insurer or did you source / appoint them yourselves? Also, is there a Loss Adjuster involved?

this is the crux of the matter...

If they appointed and instructed the contractors, tell them that you are happy for the old fronts to be used, and that THEIR contractor should see to this. Their problem is with their contractor so any costs should be sought from them.

If you instructed them, its a bit more complicated...

InsideInsurance

martinsurrey wrote: »

If you instructed them, its a bit more complicated...

Not complicated at all, simply between you and your contractor

gazb84

Thanks for the various replies.


Just to clarify, the conversation was held between myself and the loss adjuster, acting on behalf of the insurer.


It was actually suggested to me, that the doors could be retained and I was more than happy with this approach.


I would therefore expect the same discussion to be had between the LA and the contractor (their appointed contractor, not mine). After all, the LA's job is to mitigate the claims cost.


The fact that said conversation was not held between those two parties is not my problem.


As an underwriter myself, I understand the intention of the matching sets clause and the application of such clause under certain circumstances. Though I do have major issues on how this can be applied to replacement of 70% of my damaged kitchen, leaving 30% as non matching unless I contribute to the cost myself. This does not reinstate me to the same position as before the loss occurred. Hands up, I should have read the small print being in the job I am. I know there is proven cases upheld by the FO/FCA in favour of the insurer but my point of argument is the retention of the original doors and the lack of communication between LA and contractor in doing so.


Cheers

InsideInsurance

gazb84 wrote: »

As an underwriter myself, I understand the intention of the matching sets clause and the application of such clause under certain circumstances. Though I do have major issues on how this can be applied to replacement of 70% of my damaged kitchen, leaving 30% as non matching unless I contribute to the cost myself. This does not reinstate me to the same position as before the loss occurred. Hands up, I should have read the small print being in the job I am. I know there is proven cases upheld by the FO/FCA in favour of the insurer but my point of argument is the retention of the original doors and the lack of communication between LA and contractor in doing so.

If you are an underwriter then you should know that not all insurance works on the principle of indemnity. Most Home insurance is actually betterment because of the New for Old clause and pricing reflects the moral hazard this creates.

FOS cases may be upheld or reject depending on what both parties wanted. In the older cases most complaints were partially upheld as the insurer was offering nothing towards the undamaged parts and the insured wanted 100% contribution to them. The FOS decided that contrary to terms a 50% contribution was "fair". Now more complaints are rejected as insurers are aware of the normal FOS ruling so apply it but inevitably pricing now reflects the additional coverage they are forced to give.

If you want a full fat policy you need to look at the HNW providers where matching sets, trace and access, all risks basis are the normal level of cover but there is a notable price to pay for all this additional coverage.