House Insurance are only offering half of my claim

FleaDee

Hi,
I have recently had to claim on my house insurance for water damage from a leaking pipe in a downstairs bathroom. The leak had obviously been happing for a while before it was noticed and meant the floor had all rotted and tiles, plaster etc all had to be removed. It had also gone under the floor into the adjoining room, which also had to have part of the floor & wall replaced.  
I notified the insurance the minute it was found and obtained a quote. I informed the insurance that this bathroom needed to be fixed quickly as it was the only bathroom and toilet that my 90 year old mother could access in the house, because she cannot climb stairs and is partially sighted.
I took all photographs  & videos as they informed me to do and progress of the work as it was all being repaired.
The insurance company never replied to any of my emails and I constantly had to keep ringing them to ask if everything was progressing ok.
When the builder finally finished I submitted his invoice which was for £12,000.
Now 2 months later and after much chasing  the firstly offered me £2750, which I refused. I asked for a breakdown and for them to re-look at how they had arrived at that figure.
They have now come back and offered me £5733.29.
I have again asked for a breakdown on such an odd figure. They have sent through a breakdown  of what they estimate it should be in times and materials, but does not include any prices. It only states the time of plasters, labourers etc & flooring & walls. It does not include a plumber. They are refusing to pay for the new shower, toilet etc. My builder has said that he would never replace the sanitary wear with the old items that he has taken out because he cannot guarantee them. They obviously will not pay for the skip either, because they did not feel it was necessary.
My builder is now demanding his money, but the insurance are only offering half.
Any help and advice that anyone can give will be greatly appreciated.

SaverRate

Whos the insurer?

turnitround

I'm not really surprised they are not paying out. From having a leak and the damage repaired it has turned into a major job.

Your plumber should have found the cause of the leak and fixed it. Why did he need to remove all the shower and toilet simply to find a leak? For such a big job I'm sure you would have had to supply the insurance company with quotes for the work and get them ok'd.

TELLIT01

I can understand removing the shower and toilet as the flooring needed to be replaced.  However, he should have reused the toilet at the very least.  I suspect he has a healthy mark up on the prices of the replaced items.  Often, insurers want their assessor to view the damage before agreeing to work being done.  Was that not required in this instance?

DullGreyGuy

Sounds like your builders took you for a ride saying you had to replace the sanitary ware when the original were not damaged by the escape of water. Unfortunately there is ultimately a risk in deciding to proceed with your chosen supplier before the insurer has had a chance to review the claim.

FleaDee

I had explained to the insurance the urgency of the claim. The floor had rotted & had sunk by about inch around the shower & toilet which is a major trip hazard for a partially sighted 90 year old.
They just said to send in videos of all the damage once the lino was all taken up, which I did.
All quotes were sent in and never at any point did they not tell me not to continue, they just said to keep sending in photographs as the work progressed. The damage meant all the tiles had to be removed from the walls & plasterboard & floors replaced in two adjoining rooms. The rooms obviously then needed new lino & re-decorating as well, which again the insurance have not taken this into consideration.
I just don't understand how the insurance can give me a price on what they will pay, but won't include the prices so I have no comparison on what the builder is charging against their offer. Their labour rates for labourers, plasterers etc might be minimum wage for they are offering and they have not included the price for a plumber. Surely this cannot be a way to offer me a settlement figure?
I have attached some photographs, so that you can see that the damage was quite major and why the shower & toilet etc had to be removed.
Maybe the builder charged a premium for the urgency of the job knowing it had to be replaced quickly for my mother. He has given me a breakdown of costs and it all seems reasonable, but he has not also quoted his labour rates but just the prices for each individual item i.e. remove plasterboard, re-plaster & skim £1280, remove wall tiles £380 etc etc. after everything in both rooms it came to the £12000.

Again, any comments/help is greatly appreciated.


This is how the floor looked when we first noticed it was sinking & I contacted the insurance.


After pulling back the lino & realising how rotten the floor was.


After the lino taken up & shower removed



The floor in the adjoining room behind the bathroom/shower

DullGreyGuy

What does your policy book state about matching sets? 

Most basic and standard policies exclude matching sets and as such they'd only cover the tiles that needed to be removed which I'd be surprised was every tile on all 4 walls. Yes that does mean if you buy on price its likely you'll end up with mismatched tiles in the event of such a claim (the ombudsman typically makes the insurer contribute 50% towards the remainder where it would be very ugly and there is no realistic alternative option -  carpet that goes over multiple rooms for example they wont; insurer replaces the damage room and puts a door bar on and ombudsman accepts you now have one room with a different carpet)

Obviously this is a bit clutching at straws to what the rational is, you ultimately need to log a complaint and in that complaint ask for their justification for their number.

TSx

Can you say who the insurer is?

The strange figure they've given is usually generated by a tool which generates a scope of work (products such as Symbility or Xactimate and in theory, prices it up based on local rates. I worked in home claims a long time ago and hated this software as all it does is provide a theoretical price for the work to be carried out, rather than an actual cost (which they would get if one of their surveyors went out). I suspect the first handler added all the bits they could and someone has then gone back and added in extra required work and possibly changed the contractor rate (they usually have a figure for e.g handyman, local contractor, national contractor).

The way you've gone about it hasn't helped i'm afraid - for work of that size, I would expect a second quote at least. Skip hire isn't always necessary as a hippo bag or similar probably would have been appropriate. I've also never heard of sanitary fittings being unable to be reused before. Plumbers don't generally replace every toilet they're asked to fix so the bit about require new fixtures sounds rubbish. Finally, as pointed out, matching sets are usually not covered so they'll only cover 50% of the tiles which required replacement but were undamaged (if there are any). They also wouldn't usually pay for the plumber to fix the leak (but this is unlikely to be more than an hour or so of the total labour).

All in all, I think getting £6k back is probably not a bad offer.

That said, I think you have a reasonable argument that the Insurer did not help based on what you've said - I would make a complaint and highlight your attempts to get approval beforehand (they will have call/email records), the fact the work was required urgently due to it being the only bathroom and the lack of support from the Insurer.

I think it is unlikely they will raise their offer to the full price but you may get either a slight increase or a goodwill payment.

Exodi

Having recently spoke to an insurer about an 'escape of water' claim (what they refer to it as), I learned a few things.

The insurer does not cover the costs to repair the actual leak (as in the costs associated with replacing a seal or replacing pipework), I found this quite surprising but generally these costs are relatively low. Secondly a different excess applies for claims of this nature (it was £500 instead of my standard £250 excess).

When I asked what it does cover, they said 'access costs' (e.g. having to remove tiles or floorboards to get to a leak) and redecoration.

Before they would consider or approve anything, they required (copy+pasted from their email):

• A breakdown of plumbing works clearly showing trace and access costs
• One estimate to repair/replace the item(s) on a like for like basis.
• Photos of the damaged Room(s) / area(s) / item(s)
• Written confirmation of the cause of damage from your tradesperson.

The repair ended up only costing us ~£100 so we abandoned the claim and just re-decorated after the repair ourselves (just needed a bit of plasterboard, some filler and a couple coats of paint). This was a mainstream insurer.

I can understand their requests, they want to make sure they're only paying for the access costs, and they also want to be sure that the leak was due to wear and tear (as opposed to me accidentally drilling through a pipe, as we are not covered for accidental damage).

To apply it to the OP's circumstances, were you asked for similar? Did you get an initial estimate? I take it it wasn't anywhere near £12k?

From my layperson perspective, the work done does seem excessive. Why did they need to remove every single tile from the bathroom? I hope they re-used them? You say the quote 'all seems reasonable' but I'm still lost on how they arrived at £12k? You can rip out and renovate an entire bathroom for new for half of that. Why do the toilet and shower need replacing if there's nothing wrong with them?

I expect the insurer might be on high alert with your case - whereby a claimant has rushed a claim though (don't get me wrong, I understand why) and then dropped an astronomically high bill on them at the end.

DullGreyGuy

Exodi said:

When I asked what it does cover, they said 'access costs' (e.g. having to remove tiles or floorboards to get to a leak) and redecoration.

Access costs will only be covered if your policy includes Trace and Access which is rare on budget policies but increasingly common on standard policies. 

Exodi said:

they also want to be sure that the leak was due to wear and tear (as opposed to me accidentally drilling through a pipe, as we are not covered for accidental damage).

Even if the leak was caused by AD you would still be covered for the EoW. If you had AD cover then in that event the repair of the leak itself would also have been covered. 

Wanting to know the cause is more likely to rule out defective workmanship, failed sealant around a bath/shower, failed grout or its a case of leaving the taps running as all of these typically are excluded from EoW claims. 

FleaDee

I don't really want to name the insurer at this point, because I have already logged a complaint about the way the whole case has been handled & the settlement figure offered.
However, after now looking at their reviews on Trustpilot I do wish I had looked at this first before ever taking a policy out with them because they only score 3 and have many complaints on there.
I did get a second quote which was slightly more, although that builder never confirmed it in writing but I did tell the insurance. One of the difficulties I always have is that it is a large house so I think the price goes up the moment every workman sees the building. What they don't realise is it is that large to fully accommodate my mother who paid towards it and also a big house does not mean you earn big money.
I was at work most of the time the building work took place so I would come home and things had been replaced etc. I know nothing about building work or insurance claims so assumed it was all ok (a hard lesson now learnt).
My policy book doesn't actually mention anything about matching sets or even new for old. Its very basic.
Thank you all for the advice so far. Fingers crossed that I get offered another settlement that is slightly better.