Burst pipe large claim need advice

EdwinRobertson

Dear MSEers,

This is my first post and we really are in need of advice and help.

We just bought our first house and we went out for Christmas holiday several days after entering the house (we intended to move in earlier but there was some hiccups during the transcation which caused delay). We left the keys to our neighbor and was contacted by her in shock that our house was flooded due to a frozen and burst pipe in the loft. The damage was substantial (ceilings in most of the rooms crashed and the walls and floors were soaked in water) and the house became uninhabitable.

We flew back as soon as we could and contacted our insurance company (Esure) right away asking for suggestions. Following their instruction, I called a plumber to fix the bursting pipe. We didn't buy content insurance, so after getting permisson, we moved the existing furniures in the house to the garage and our rented apartment and stripped out the carpets by ourselves to help with drying. After realizing it's a large claim, Esure appointed Cunningham Lindsey to deal with our case. The surveyor mentioned that it would be a straightforward process to strip the house and reinstate it. At that point of time, I was relieved that they were going to cover the repairs. I wasn't sure whether we would want to use the surveyor appointed by the insurer or having a surveyor that would represent our interests. Since we really didn't know what should be the proper scope of repairs and read some negative reviews online about insurance company cutting corners, we decided that we would like to employ our own surveyor, whose appointment was approved by the insurer.

Then, right at this point of time, things start to get very complicated. CL passed our case to another department due to "the size of the claim". Then, it seems to me that they are trying to find ways to flip the earlier decision of accepting the liability and escape from liability. We were asked to provide lots of detailed information. Then, an investigator came to have a recorded 2hr conversion with us asking lots of detailed questions such as how long we were at the house, whether the house was heated etc. We answered with best of our knoweldge and with outmost honesty. We were in the house several days during the day but didn't stay overnight. During our stay, the house was heated. Since we just moved from a warm climate and didn't realize there would be the possibility of pipe burst, we didn't intend to keep the heater on, even though my husband might actually have left the heater on. There is a "once" setting on the control panel which he thought would only run once, but actually have turned on the heat once every day. The days when we were still here, outside timperature was all above zero. It was two days after we left, the temperature plummeted to a record low of -5 or -7.

CL later sent an engineer from a forensic company to check the plumbing system. After checking the system, the engineer told us that reason for the pipe burst is likely to be that the attic was insulated so the heat from below could not enter the attic. Then, he asked to take the pipes with him to check using microscopy. We were a bit concerned that this is a piece of evidence for us as well, but he assured us that he works independently (using his own words, "not an insurance company slave") and we can claim the pipes back. So, we let him take the pipe with him. However, now I am really worried that we could not get the pipes back and the insurance company will find a reason to reject our claim saying that the bursting was caused by wear and tear. We took photos of the pipes, but not sure whether that's enough. The burst is at a plastic joint and the pipe is copper. The joint is not actually broken, but it was seperated from the pipe. It's a push fit system with the joint being pushed out by the expanding ice. Now we lost the evidence, I'm worried that they would use it against us.

In your opinion, could the insurance company use any exclusions to reject our case? Now two months after the accident, the stripping hasn't started so I'm really afraid of mould growing in the joists and walls. I have chased with many calls to CL, but there was always delay with our case being passed over to 4 loss adjustors consecutively. They were responsive, but they were slow. The engineer from the forensic company said that usually he would be called within 2-3 days of the accident, but in our case, he was not called in until two months later.

I would really appreciate your help and advice on the way forward. Sorry for the long post.

EdwinRobertson

These are the relevant terms in the policy booklet. Please help us. Thank you!

7.Escape of water/burst pipes
What is covered?
We will pay for loss of or damage to Your Buildings or Contents as a result of water escaping from water
tanks, pipes, fixed equipment, any domestic appliance or fixed heating systems, or as a result of water
freezing in water tanks, equipment or pipes.
What am I not covered for?
We will not pay for loss or damage:
!!!8226; if Your House is Unfurnished or Unoccupied
!!!8226; caused by overflowing water from wash basins, sinks, bidets, showers, and baths as a result of the taps
being left on
!!!8226; caused by failure or lack of appropriate sealant and/or grout
!!!8226; caused by gradual operating cause
!!!8226; to the tank, pipe or installation itself if caused by normal wear and tear
!!!8226; to Your Buildings resulting in Subsidence, Heave or Landslip caused by the escaping water.

alone or on behalf of or in connection with any organisation(s) or
government(s) committed for political, religious, ideological or similar purposes including the intention
to influence any government(s) or put the public or any section of the public in fear.
Confiscation
!!!8226; items being confiscated or legally taken by customs officers or other officials.
Wear and tear
!!!8226; wear and tear
!!!8226; loss or damage as a result of the lack of maintenance
!!!8226; loss of value over time; or
!!!8226; loss or damage that happens gradually over time (for example, loss or damage as a result of wet rot or
dry rot, or loss resulting from wet rot or dry rot, rusting, corrosion, the affects of light or the atmosphere,
damp, condensation, fading, moths, vermin, birds, insects, fungi or other gradual deterioration).
Indirect loss
We will not pay for any losses or expenses that are not directly associated with the loss, damage or incident
resulting in an insurance claim, unless Your Policy specifically says that We will cover such losses or
expenses.

Other exclusions
We will not pay for loss, damage or any liability resulting from or consisting of:
!!!8226; the costs of replacing or repairing electrical or mechanical equipment that has broken down or been
misused
!!!8226; faulty workmanship, design or materials
reduced value after an item has been repaired or replaced
!!!8226; loss or corruption of computer software or data caused by computer viruses, malfunction, user error or
where no adequate back-up copies have been kept
!!!8226; loss of or damage to any item owned or used totally or partly for business purposes or connected with
any employment (except property defined as Office Equipment)
!!!8226; loss of or damage to any business stock
!!!8226; any loss or damage that happened before the Period of Cover started
!!!8226; loss of or damage to any goods while being transported via postal, parcel delivery, courier or similar
delivery service
!!!8226; loss or damage caused or allowed to be caused, deliberately or wilfully by You or any of Your
Household, paying guest or tenant
!!!8226; theft of personal effects from a vehicle, unless they are kept in a locked boot, locked glove compartment
or concealed luggage compartment of a locked Motor Vehicle
!!!8226; the cost of complying with building regulations, local authority or other statutory requirements, if a
notice of the need to comply with any of them was sent to You or Your Household before the loss or
damage happened or if the notice relates to undamaged parts of Your Buildings
!!!8226; any extra cost of altering or replacing any item or parts of an item which are not lost or damaged and
which form part of a set, suite or other article, of the same type, colour or design including wall or floor
coverings.

paddyandstumpy

EdwinRobertson wrote: »

Dear MSEers,

This is my first post and we really are in need of advice and help.

We just bought our first house and we went out for Christmas holiday several days after entering the house (we intended to move in earlier but there was some hiccups during the transcation which caused delay).
So you never moved in?
We left the keys to our neighbor and was contacted by her in shock that our house was flooded due to a frozen and burst pipe in the loft. The damage was substantial (ceilings in most of the rooms crashed and the walls and floors were soaked in water) and the house became inhabitable.

We flew back as soon as we could and contacted our insurance company (Esure) right away asking for suggestions. Following their instruction, I called a plumber to fix the bursting pipe. We didn't buy content insurance, so after getting permisson, we moved the existing furniures in the house to the garage and our rented apartment and stripped out the carpets by ourselves to help with drying. After realizing it's a large claim, Esure appointed Cunningham Lindsey to deal with our case. A loss adjuster and a surveyor visited and then I was emailed that the insurer has accepted the claim. The surveyor mentioned that it would be a straightforward process to strip the house and reinstate it. At that point of time, I was relieved that they were going to cover the repairs.
You haven't stated that they agreed to the claim at this point, merely that they said it would be a straighforward process to restore.
I wasn't sure whether we would want to use the surveyor appointed by the insurer or having a surveyor that would represent our interests. Since we really didn't know what should be the proper scope of repairs and read some negative reviews online about insurance company cutting corners, we decided that we would like to employ our own surveyor, whose appointment was approved by the insurer.

Then, right at this point of time, things start to get very complicated. CL passed our case to another department due to "the size of the claim". Then, it seems to me that they are trying to find ways to flip the earlier decision of accepting the liability and escape from liability. We were asked to provide lots of detailed information including home report, airtickets, plumber's photos etc, which we provided immediately. Then, an investigator came to have a recorded 2hr conversion with us asking lots of detailed questions such as how long we were at the house, whether the house was heated etc. We answered with best of our knoweldge and with outmost honesty.
We were in the house several days during the day but didn't stay overnight because there was no internet in the house. I'm sorry this is carp. You were in the house during the day, when you are awake, but didn't need the internet, then left overnight to sleep elsewhere (keep word is sleep) because there was no internet? How does the internet help you sleep?
During our stay, the house was heated. Since we just moved from a warm climate and didn't realize there would be the possibility of pipe burst, we didn't intend to keep the heater on, even though my husband might actually have left the heater on. There is a "once" setting on the control panel which he thought would only run once, but actually have turned on the heat once every day. But we are still not sure whether the heat was on. The days when we were still here, outside timperature was all above zero. It was two days after we left, the temperature plummeted to a record low of -5 or -7. So, this is really something unforeseen. It's currently winter in the UK. Cold weather tends to happen this time of year.
CL also called our friend who was in the house with my husband, our neighbor who informed us of the accident, the plumber who fixed the pipe and the previous owners. They all answered their questions with best of their knowledge.

CL later sent an engineer from a forensic company to check the plumbing system. After checking the system, the engineer told us that reason for the pipe burst is likely to be that the attic was insulated so the heat from below could not enter the attic. Then, he asked to take the pipes with him to check using microscopy. We were a bit concerned that this is a piece of evidence for us as well, but he assured us that he works independently (using his own words, "not an insurance company slave") and we can claim the pipes back. So, we let him take the pipe with him. However, now I am really worried that we could not get the pipes back and the insurance company will find a reason to reject our claim saying that the bursting was caused by wear and tear. We took photos of the pipes, but not sure whether that's enough. The burst is at a plastic joint and the pipe is copper. The joint is not actually broken, but it was seperated from the pipe. It's a push fit system with the joint being pushed out by the expanding ice. Now we lost the evidence, I'm worried that they would use it against us.

We had moved some of our personal belongings inside the house and the house was furnished as the previous ownes sold most of the existing furnitures to us. So, I think the insurer could not reject our case saying that this was unfurnished. Neither could they reject us saying that it was unoccupied, because their definition of unoccupied is 30 days, even though you'd never moved in while the accident happened within a week of us leaving the house. We also stayed in the house during the day before the holidays. In addition, there is also no term in the policy that says the house must be heated while we are away and no reminder email was sent us to alert us of frozen pipe possibility you honestly expect someone to email you to tell you something might happen? Where does this end?

In your opinion, could the insurance company use any exclusions to reject our case? Now two months after the accident, the stripping hasn't started so I'm really afraid of mould growing in the joists and walls. I have chased with many calls to CL, but there was always delay with our case being passed over to 4 loss adjustors consecutively. They were responsive, but they were slow. The engineer from the forensic company said that usually he would be called within 2-3 days of the accident, but in our case, he was not called in until two months later.

I would really appreciate your help and advice on the way forward. Sorry for the long post.

Aside from my answers in red to your essay; if you are unhappy at the length of time the insurer is taking over claim validation then raise a formal complaint, the process of which will be in your policy book. This will normally get them moving.

pramsay13

In my experience CL are very poor and on the second occasion I contacted my insurer and complained that I didn't want CL due to first poor experience and the way the second one was already shaping up.
The insurer took the case back and dealt with it themselves.
Your options are complain to CL that it is taking so long and can they give you someone to manage your case and keep at them.
Complain to insurer and ask them to manage your case directly.
Once done you can complain to the ombudsman.

EdwinRobertson

Thank you for your reply.

We considered ourselves as moved in because we didn't have much furniture at our rented apartment. And we have moved some personal belongings to the new house, which have majority of our furniture. When we left, we have 4 checked luggages with winter clothes which we will move directly back to the new house after we come back from holiday. So there is really not much left (summer clothes, some cookwares) in the rented apartment. We moved to the UK not too long ago with 6 checked luggages and we didn't buy much stuff.

Regarding the internet, it's not that we need it for sleeping. During the day, we spent hours cleaning the house and working on things that do not need internet. But then in the evening, some of the work needs to be done using internet. So we went back to the rented apartment, then continue staying there for the nights.

EdwinRobertson

Forgot to mention, they have formally accepted liability by emailing us before we got a quation from a local contractor regarding stripping cost.

EdwinRobertson

Thank you. It is really frustrating and stressful. If we don't hear from them in the next week or so, we will start with the formal complaint procedures.

rs65

I don't think wear and tear would be an issue, nor the heating point.

Have a look at what you told them when you took out the policy. Most insurers ask if it is your main residence and if it is occupied during day and night.

Having a large claim within days of taking out a policy will require investigation.

EdwinRobertson

rs65 wrote: »

I don't think wear and tear would be an issue, nor the heating point.

Have a look at what you told them when you took out the policy. Most insurers ask if it is your main residence and if it is occupied during day and night.

Having a large claim within days of taking out a policy will require investigation.

Thank you. These are the questions

Is the property occupied permanently and solely by you, members of your family and any joint
named policyholder? Yes
Is the property ever left unoccupied for more than 30 days? No
Is the property regularly occupied overnight? Yes

When we answered the above questions, we would be expecting to stay overnight in the property long term since it is our faimly home.

Thank you. Do you see any issues in the above question?

rs65

EdwinRobertson wrote: »

Thank you. These are the questions

Is the property occupied permanently and solely by you, members of your family and any joint
named policyholder? Yes
Is the property ever left unoccupied for more than 30 days? No
Is the property regularly occupied overnight? Yes

When we answered the above questions, we would be expecting to stay overnight in the property long term since it is our faimly home.

Thank you. Do you see any issues in the above question?

So the first and last were answered incorrectly?

EdwinRobertson

rs65 wrote: »

So the first and last were answered incorrectly?

I don't think we answered them incorrectly. This is our main house and the reason our rented apartment is still available is because we signed a minimum 6 month lease, which we would need to pay to the end. And the last question, at the time we took out the insurance, we plan stay regularly over night since it is our main house.