Claim refused question

baz8755

Several months ago during an unseasonal outburst of weather we discovered a leak in our roof.

We called our insurance who sent an assessor. The assessor decided it was a failed repair and turned down the claim.

We got a roofer to repair the roof and he said the leak was not at the point of the repair the assessor found but obviously we got the work done.

So I have 2 concerns
1) What is the likelihood of being able to challenge the assessors findings and get my insurers to reconsider?
2) Does the fact my insurers refused the claim affect my future ability to get insurance?

user1977

So what did your roofer think the cause of the leak was? It doesn't sound like it was likely to be an insured risk from what you've said.

baz8755

user1977 said:

So what did your roofer think the cause of the leak was? It doesn't sound like it was likely to be an insured risk from what you've said.

He didn't actually say a cause but he had to replace the flashing around the chimney 

Aretnap

Home insurance is usually defined in terms of the things that it does cover (insured perils, to use the jargon), rather than the things that it doesn't cover. The policy will have a list of insured perils - fire, flood, storm damage, subsidence, collision with vehicle etc etc - and if you want to make a claim you have to say which peril you think caused the damage. Realistically the only one which might have caused a leaky roof is a storm - and to make a claim you would need to show that the damage was caused by a specific storm. The fact that a leak which might well have been caused by long term wear and tear first became apparent during a spell of bad weather isn't enough to make a claim for storm damage - after all it's hardly going to become apparent during a warm dry spell.

The exception to the above is if you have an "all risks" policy. Unlike an insured peril policy these are defined along the lines of "we will cover any bad stuff that happens to your house except for..." followed by a list of exceptions. The outcome would probably be the same because wear and tear and routine maintenance are standard exclusions (these are just part of the joy of being a homeowner). But if the cause of damage is unclear a policy like that does put the onus on the insurer to prove that a cause is excluded, rather than on the customer to prove that it is covered.

A declined claim will not have a major effect on your ability to get insurance in future. You don't have to tick the box to say that you have been refused insurance or had a policy cancelled - those are very different things to asking is something is covered by your policy and being told "no". However you may find that your insurer has recorded it as a claim (especially if they've incurred expense sending an assessor round) and if so you will have to declare the claim for the next 3-5 years when getting quotes. A single claim shouldn't make a huge difference to your permium though.

DullGreyGuy

baz8755 said:

So I have 2 concerns
1) What is the likelihood of being able to challenge the assessors findings and get my insurers to reconsider?
2) Does the fact my insurers refused the claim affect my future ability to get insurance?

A standard policy is insured perils, as noted above, and so for you to challenge them you would need to show that the damage was caused by one of those perils. For things like Storm you would need to be able to pinpoint the time/date of the storm. The insurance policy book most likely will define storm in terms of a minimum windspeed and/or rate of rain. 

Wear and tear, poor workmanship, gradual damage building up etc are almost universally excluded from Home insurance, its intended to cover events (pipe burst, hurricane rips off your roof, thief breaks in and nicks stuff) and isn't a home maintenance contract