Leak from bathroom, fixed but now insurance wont pay

Eve1

Hi everyone,

Could anyone offer a bit of help here? We noticed a leak coming occasionally from a shower upstairs through the ceiling. It came and went and i informed the insurance but read that if its sealant related, it wouldnt be covered. So we resealed ourself and continued to use the bathroom from time to time but then later again saw the leak coming through.

I spoke to the insurance and they said go ahead with the repair as i had trace and access. My broker also spoke to them and they said the same thing. As i was uber worried, i phoned them a few times before getting the plumber in and all said go ahead. Then when i spoke again, the insurance said they wanted to send a loss adjuster in. I said fine but the work was starting already and they said ok. After about a week of chasing, the loss adjuster finally came round.

Anyway, to cut a long story short but i got the bathroom fixed and retiled with the cheapest tiles, and now the loss adjuster has said they wont cover it. They said that i shouldnt have used the shower at all (as i had another bathroom) and hence the damage is my fault. My broker then went back to them challenging this and they have reopened the case and spoken to the plumber directly. However im panicking now because the work has been done and i assumed id be covered.

Could anyone tell me my rights, should i be speaking to the ombudsman or shouldnt i have done any work before the loss adjuster. They told me several times by phone to go ahead but i have nothing in writing. I would never have started the work had i known they wouldnt cover anything.

Any suggestions would be appreciated

System

My recent experience is that insurers will not pay for repairs, only for the consequences of the fault.
One is maintenance, which is not covered, the other is damage, which is.

Quentin

You will have to wait and see what your insurers say about all this.


If you don't like what they say then you need to first make a complaint to the insurer about the handling of your claim then if you are unhappy with the reply (or they ignore you for 8 weeks) you can go to the FOS for their adjudication at no cost to you.


You shouldn't contact your insurer unless you are certain you can claim.


This is because when you report a loss it goes down on your record even (as happened) no claim can be made.


From what you say you now have 2 incidents/losses on your history which you must now disclose to other insurers you approach for quotes over the next 3/5 years depending on how long a history they want.


This will impact your future premiums

Eve1

Hi Quentin,

Thank you for this - its only this one claim that i am trying to resolve but i went through my broker who spoke to them and said it was all fine as i had the trace and access in my policy. The insurance company say the loss adjuster is saying its a no but she did say she will look into it again and has been speaking to the plumber who did the work.

I guess i was just wondering if say she comes back and still says no, then it sounds like i can put in a complaint. My concern is they said go ahead but now are saying no. Im fine to pay for the cost of the pipes etc but its the tiles/rest of the bathroom, walls etc which need fixing because all were damaged in the process.

Quentin

Eve1 wrote: »

....its only this one claim that i am trying to resolve.....

According to your OP you informed your insurer about a leak but were told you weren't covered as it was a sealant related issue.


That was your first loss that will now be on your record.


You now have a separate claim that you are resolving.


That will be your second loss and now also on your record