Insurance company won’t oay

alijp

On Sunday a window in our house smashed. It’s a modern house and a huge piece of glass. We weren’t in the room so don’t know how or why. We have occassional bird strikes but there was no dead bird and it would have to have been a pheasant to break that glass. Anyway, we’ve been with the same insurance company for 4 years. They previously paid out on a smashed window caused by a stone from a lawn mower. We’ve continued to insure with them as they were so efficient when it happened. They are refusing to pay this claim because they say we don’t have accidental damage despite having paid out on it before. We have building and structural insurance that covers the roof too and given large parts of the structure of this house are made up by huge walls of windows I cannot understand their logic. And what isn’t accidental damage?! If it was on purpose they wouldn’t pay anyway! Thoughts? 

user1977

Well, does your current policy include accidental damage as an insured risk? Even if it does, what was the accident?

Sandtree

Most home insurance is written on a insured peril basis which effectively means that it is your duty to substantiate that the cause of the loss is as a direct result of one of the perils listed (fire, theft, vandalism, accidental damage etc). Much rarer are all risk policies which effectively spin the table and basically everything is covered unless the insurer can show the cause of loss is as a direct result of one of the listed exclusions.

The problem here is you have been unable to substantiate the cause the damage and as such have not proven it was an insured peril (on the balance of probabilities). There was a similar case on the forum the other day where just the inner side of a double glazed unit broke whilst everyone was out the home and the insurer declined as it seemed most likely to be a manufacturing/fitting issue... had someone thrown a brick at the window etc you'd expect the outer glass to break before the inner.

Aretnap

alijp said:

On Sunday a window in our house smashed. It’s a modern house and a huge piece of glass. We weren’t in the room so don’t know how or why. We have occassional bird strikes but there was no dead bird and it would have to have been a pheasant to break that glass. Anyway, we’ve been with the same insurance company for 4 years. They previously paid out on a smashed window caused by a stone from a lawn mower. We’ve continued to insure with them as they were so efficient when it happened. They are refusing to pay this claim because they say we don’t have accidental damage despite having paid out on it before. We have building and structural insurance that covers the roof too and given large parts of the structure of this house are made up by huge walls of windows I cannot understand their logic. And what isn’t accidental damage?! If it was on purpose they wouldn’t pay anyway! Thoughts? 

With many home insurance policies, accidental damage cover is an optional extra that you an buy at extra cost.

In other words, the basic policy comes with a list of perils - fire, flood, storm damage, subsidence, collisions with vehicles etc etc. If you want to make a claim, you have to be able to point to the peril which you think caused the damage that you're claiming for.

Some types of accident (eg cars colliding with your house, accidental fires) are already covered under the standard perils, but if you add accidental damage cover you are covered for any other type of accident, such as putting your foot through the ceiling while you are in the loft, or bird strike or a lawnmower/stone incident breaking your window. (You would still have to show that the damage was indeed caused by an accident, rather than a manufacturing defect, but if the insurance company are telling you that they're not paying because you don't have the right cover then presumably they've accepted that it was most likely an accident of some sort).

There's a certain logic to accidental damage being an optional extra. The standard perils are the big things - if your house burned to the ground and you weren't insured then you would be homeless or bankrupt. But the type of accidents that aren't covered under one of the standard perils tend to be relatively minor in comparison. Some people would rather take the risk of having to pay for a broken window or a hole in the ceiling themselves than pay extra for their insurance.

It's odd that they are saying that you don't have accidental damage cover given that they previously paid out for a lawnmower/stone incident, but it's possible that they've changed the terms at a renewal date between now and then. If they did then they should have highlighted the changes clearly in your renewal letter so that you could make an informed choice about whether the policy was still suitable for you - if they didn't then you may have grounds for complaint.