Ongoing battle with loss adjusters over subsidence claim

Bluntington88

Hi, hope some of you might have experienced some of my issues with AXA’s loss adjusters. Advice very much appreciated. Here goes:
over 3 years ago we put in a claim for internal and external cracking. We then had 18 months of monitoring through sensor points around the building. The results were interpreted as tree interference and clay soil and seasonal variation. Tree was reduced twice by 1/3 with monitoring continued. The soil readings continued to vary and cracking worsened. We were then told they would  internally repair and close the claim. We refused.
They then applied to take the 250 year old TPO tree down and were refused by the Council. 
In the meantime, we instructed a qualified Structural Engineer who compiled a 52 page report after site visit and analysis of all data. 
They are now offering root barrier treatment for half the circumference of the tree against the explicit advice of the engineer who stated underpinning was needed. 
The loss adjusters refuse to acknowledge the structural engineer’s  report and refuse any meeting or discussion. They repeat they are coming to do root barrier treatment ignoring concerns repeatedly stated in our emails. We have had to resort to telling them they cannot come on the property until they agree to discuss the structural engineer’s report which advises root barrier treatment is equivalent to taking a tree down in its effect of re-hydrating the soil which could then cause heave.
Desperate for any experiences and advice to help with this saga. 
Thank you 

Annemos

I have seen cases on the FOS site about this issue. I did not save them, because the trees in my case were removed.

It will take a little time. But I would do several searches on "Insurance" cases.    Search on   "Subsidence TPO"    and "Subsidence Root Barrier"   and  "Subsidence Heave"  and "Subsidence Underpinning"      etc.   (Link at bottom.) 

I spent a long day once going through many cases. They were incredibly helpful about what is expected to be done.

Also note, that if you stay too long on a case, the website may time out and you have to go to the beginning and start again. So, save any straight away that you think are relevant. Then move on to the next in the listing. 

(From memory, I do remember cases where if there was still a dispute, the FOS might order the Insurance Company to get a third opinion. So they would have to find 3 new Surveying companies and the Homeowner could choose which one to do the 3rd survey.) 

I think you should do the search to get as many cases as you can about this issue, as soon as possible. Then if necessary, you may decide to submit a formal complaint to your Insurance Company. (Details are in your policy how to do this.)   This will also make them realise you are serious about the issue. They have to reply within 8 weeks. Then you can go to the Ombudsman if you still disagree with their reply. 

(My Claims Handler-"Engineer" did not take me seriously, until I submitted a formal complaint.)

In my case, the Ombudsman did look at my own reports and checked out the Structural Engineering company I had used, to see that they were reputable. 

Here is the link. Very best of luck to you. I know how very stressful this is. And you are new to posting, too. I do hope this reply helps. Keep fighting! 


https://www.financial-ombudsman.org.uk/decisions-case-studies/ombudsman-decisions

Annemos

This case was discussed in the general notes on the Ombudsman site. 


https://www.financial-ombudsman.org.uk/decisions-case-studies/case-studies/insurer-says-not-liable-preventative-work-investigation-found-otherwise

Bluntington88

Thank you very much. That’s useful and constructive advice. much appreciated that you took time to help 

Bluntington88

Update to my Post: have contacted insurer and the Complaint  has now been registered. The Claim handler from the Insurance company is going to call to discuss the problems and has asked us to send her the last letter from the Loss  Adjusters threatening to cancel the Claim and to refuse to reinsure. 
More contradictions to their latest proposal of root barrier treatment as the only solution on offer have been located in their previous correspondence.  6 months ago root barrier treatment was described by them as likely to make the tree ‘unsafe’. I am wondering if Loss Adjusters have their own professional body to contact as their attitude and actions have been and continue to be intimidating and contradictory. 
Thank you for any further advice. 

Annemos

I can only give my own impression of what happens during a Subsidence claim, having gone through one myself. 


I found out in my claim, that my "Loss Adjuster" was actually a "Claims Validation Company Employee".

Thus my company was NOT regulated at all by the Chartered Institute of Loss Adjusters.

I will do a summary of what I read on-line, at the bottom of this posting. 

(In your case, take a look at the Company website for the company who is handling your claim and see if you can see if they are indeed a member of the CILA. If not.... do the research I did, into the one who IS doing your claim. What exactly is that Company?)


Thus, I came to the conclusion that the only course of action I could take was against the Insurance Company itself, via the Financial Ombudsman. 

No matter how long the chain is in an Insurance claim....... Insurance Company    to    Managing General Agent   to   Claims Validation Company    to     Contractors sent out to one's home on the Claim......

.....  it is the Insurance Company itself who is ultimately responsible and who the Financial Ombudsman holds to account over any Complaint, relating to any Company within the chain. 


Just to say.... well done for what you are doing. You are now on your way and finding out all about Subsidence claims. A voyage of discovery indeed. And a much longer and surprising voyage, than I had ever anticipated at the start of my claim! 


========================================================

Summary of what I read: 

Loss Adjusters and Claim Validation Companies are engaged and paid by the insurance company.  


Loss Adjusters tend to be regulated by the Financial Conduct Authority, and be members of the Chartered Institute of Loss Adjusters.


Claim Validation Companies are also paid directly by the insurance company. Their role is to validate your claim.  Claim Validation companies are not regulated by the Financial Conduct Authority and are therefore acting under the insurance company regulation.    (Annemos note: so that means we have to complain to the Insurance Company itself. And then the FOS if necessary.) 

DullGreyGuy

Bluntington88 said:
I am wondering if Loss Adjusters have their own professional body to contact as their attitude and actions have been and continue to be intimidating and contradictory. 

They do, https://www.cila.co.uk/cila/about-cila/guide-to-professional-conduct , but membership isn't a legal requirement to be a loss adjuster 

Bluntington88

Thank you for the advice. Have lodged a complaint.  The insurers are getting very nasty and withdrawing previous elements of their original offer eg no monitoring period after treatment, no cover for further damage whilst I refuse to accept their root barrier ‘solution’ (which 6 months ago their own experts evaluated as potentially ‘unsafe’). Very stressful indeed 

Bluntington88

ps Annemos: AXA have passed it all back to Crawfords  to deal with but my complaint is lodged now in the AXA complaints system. 
I will look up to see if they are registered with CILA. Did you represent yourself at tge Financial Ombudsnan’s hearing? 
Thank you for your advice. 

DullGreyGuy

Bluntington88 said:
Did you represent yourself at tge Financial Ombudsnan’s hearing?

The ombudsman isn't a hearing.

You submit your complaint with supporting evidence; the ombudsman asks for the same from the FS company. They often will have a conversation with you ensure they understand the key points (people tend to send very long descriptions). The Adjudicator will then issue their decision and ask both you and the company if you agree. 

If either of you don't then it will be passed to an Ombudsman who will ask each of you to provide any further comments/evidence based on the Adjudicator's decision. The Ombudsman typically will then issue a draft decision for both sides to comment on (though not always) and then will issue their final decision. You are asked if you accept it or not; the FS gets no choice, an Ombudsman decision is binding on them if they agree or not. 

Bluntington88

Thank you for this very useful clarification of the process. At what point would you use professional input for your case eg drawing up the complaint for the Adjudicator after the Insurance Company has  issued their response to your complaint with which you disagree?