Buildings insurance claim problem

friendam

Is anyone experienced to give me some advice. Claim in July for suspected subsidence. Insurance company have carried out 3 drain surveys/reports and although repairs are needed escape of water hasn't bern confirmed. Front wall cracks are increasing but insurance are stalling and whilst no evidence of cracks or problems evident or flagged at house purchase 18 mths ago I changed to a this insurance 6 mths ago and they are saying it started before their policy. However my question is. we want to get drain repairs fixed to limit any more damage if they are cause of cracks. can we accept that we pay for those repairs therefore part of the claim as in any case they may decline as gradual wear and tear but make clear that the remaining subsidence part of the claim should still be active and not closed? Thank you

MorningcoffeeIV

Can you repeat the question?

Annemos

(I did a quick search on cases to see what came up. See later.   

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


Here's what I came up with, friendam. 

First of all: 

Have the insurance company actually come to a decision via their surveyor/structural engineer, re the following........

• What is the actual cause of this Cracking?  

Has it yet been confirmed that the cracking is indeed caused by Subsidence? (Ground sinking below the building pulling the foundation down with it.)       OR  is it some other issue with the building? 

• And if Subsidence, what has actually caused that Subsidence  (eg,   "clay soil maybe with trees",    "water main leak / broken drains on sandy/gravelly soil"     ,     mining...) 

I think Morningcoffee may also have this problem: we are both not yet sure what has caused your cracking, until the above is clarified. The drain surveys seem inconclusive?? 


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So then we come to some of the other things you said and your feeling you might want to pay for the drain repairs to stop further damage..................... 


If it IS subsidence due to drains, then this case is interesting, as it says the Insurance Company should pay for the drain repairs because they have to do lasting and effective repairs. If they did not fix the drains, then their repairs would not be lasting and effective. 

https://www.financial-ombudsman.org.uk/decision/DRN-3682901.pdf

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Then we come to what you said about them mentioning    gradual damage / wear and tear / things starting before your policy started etc etc..................


This case implies that it is not typical to decline a Subsidence claim due to "gradual damage /wear and tear exclusion". In this case, the Ombudsman says that if this damage had been due to Subsidence, then they could not have used that exclusion. (This claim was correctly denied for another reason: bad workmanship.) 

 https://www.financial-ombudsman.org.uk/decision/DRN3631748.pdf



This case is a bit more complicated, but says the same thing. Basically because, if you tried to take that exclusion position, there would almost be no Subsidence claims accepted! Also it mentions that issue of damage happening where there has been a change of insurers....The ombudsman says this....


"I explained that it’s normal for an insurer to exclude damage that happened before its policy existed. This isn’t unreasonable in most situations. However, in some circumstances an insurer will choose not to apply the exclusion. This is usually for subsidence claims and comes about because of an industry agreement. I went on to confirm that insurers understand that subsidence claims can be ongoing for some time before the homeowner notices damage. If a consumer has in the meantime changed insurers, potentially some of the damage would not be covered. The industry agreed that in such a situation, as long as the damage has all occurred during the time the consumer owned the property, one of the insurers that had covered the house would deal with all of the damage. Which insurer does that depends on the timing of the claim in relation to the change of policy."  SEE BELOW RE TIMING

https://www.financial-ombudsman.org.uk/decision/DRN5599273.pdf


(Note that I opened up another case, where the chap bought the property, he had been told to get the drains checked out on the mortgage application survey ("The drains give cause for concern".)   Several years later he had not done it and the property had subsided. He put in a Subsidence claim. In that case the Ombudsman said that the homeowner should have done what he was advised in that mortgage survey, therefore he was aware of the problem. So the Subsidence had likely been going on for a long time and the Ombudsman allowed the claim to be denied in this particular case, due to the "gradually operating clause".) 

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Now your issue of there being two insurers..........     

Also if it is Subsidence, many Insurers are signed up to the ABI Subsidence Claim Handling agreement: 

• if the date of notification to your Insurer of the Subsidence claim is between eight weeks and one year of switching provider then your previous and current insurers will share the cost of your claim. (I believe that means the current Insurer will carry out the handling of the claim and then they can claim half the costs back from your previous insurer.)

You can ask the loss adjuster to find out from both insurers if they are signed up to it. (From that NFU case, I think if your current insurer was not signed up and tried to impose this clause (cause of damage starting before the policy was in place, therefore claim denied), then that should have been specifically pointed out to you at sale of the policy as a very restrictive element of the policy. )  

friendam

Thank you for researching and explaining all of the above, the current insurers are not part of the ABI the previous ones were. You have made some very valid points for us to use, we are just concerned over 4 mths on with no decision on whether they are going to repair the drains that if due to the drains it will just make the problem worse. The insurers told us they were closing the case and declining claim but after we protested they have arranged another drain survey so we really don't know what to think.We have decided to pay for an independent structural engineer inspection and report which will at least will hopefully gives us expert opinion on likely cause and remedy. I can see this going to FOS after complaining to insurers/claim handling

Annemos

This does sound almost silly. 4 drain surveys?!! 

Yes. I would be inclined to contact them in writing and say "you should be providing me with a Structural Engineer's Report. Please can I see that report. If you are not going to provide me with your own Structural Engineering Report, will you allow me to appoint my own Structural Engineer to generate a structural report for me and consider this as a cost of the claim?"

I feel the advantage of this might be that it forces them to acknowledge whether they are doing a report or not and who is doing it. And whether they have any problem with the claim. And if so, what that problem would be. It also makes them more aware that they will be being professionally monitored and it also tells them that the costs will be escalating, if an Ombudsman later finds in your favour. 

It also provides extra proof for the Ombudsman that you have tried to get a report from them. 

Do everything in writing now. And as you say, if you need to and the moment is right, then do a formal complaint. 

I used to write in big letters on the top    FORMAL COMPLAINT.       

"You should be ensuring the Repairs are Lasting and Effective" was the magic phrase that I found stopped them from doing less than was necessary, too. 


(I also wonder.... could they be delaying because they are short of available technical experts?)


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One other thing. Is your water meter showing any water going through it (spinning), when there should be no water going through the pipe? Part of my claim was that the water pipe had burst under my place, possibly due to the Insurance repair contractors, or due to the Subsidence itself. 

The amazing thing is  ......  that leak had been going on for several weeks, but water never showed up anywhere on the surface or inside. But there was a thin vertical crack inside where the water pipe was underground and a bit of cracking outside. The skirting board has also slightly shifted away from the wall. Everyone had always assumed that was just damage due to the tree root damage. 

I did not have a smart meter and only found out there was a leak when the Water Company came round to bill for their annual bill. 

The only conclusion was, that the water had been draining away downhill and through the gravelly clay downwards. But with hindsight, that water leak had also caused some cracking. 


Just to also check, I presume you are not on clay soil and that you do not have any nearby trees.





 

friendam

Yes unfortunately on clay soil. They have said they will send the report, which we assume they mean initial surveyor's visit, they have not sent anyone else  but having chased still not received it. It is an Edwardian house moved in 18 mths ago. They are saying they have google photos showing cracks in Oct 22 7 months before their policy, we have asked for them to be sent, they have sent one that does show the crack but it is one of the ones I sent with my claim I have looked at google. can't find Oct 22 but March 23 photo shows no cracking and exactly the same as estate agent's photo Feb 22! Interesting point on the water leak not showing up initially. Water meter output seems ok. Tree survey all fine. Cracks are still appearing so obviously something is still happening to the front of the house.

friendam

I see Sandtree. who worked in the insurance area,  gave you some invaluable input maybe my post might be seen by them.

Annemos

I was never 100 per cent sure (99.999%)  .... but I believe he is now called DullGreyGuy. He is my hero! My claim turned me into "Even Duller Grey Woman"! 


How very odd. If they have not got any proof, then they cannot say the crack was there? (They might have the idea to say that when you took out the policy, you were asked if there was any cracking and you had said no.)

But also, we homeowners are not property experts. We don't go round looking for cracks if we are not expecting them. I only spotted mine when I came back from a holiday in August 2018 and there was suddenly a whole load of zig-zag cracking on the corner. 5mm wide. 

(I did not even know what Subsidence was, I was such a novice! I had the vague idea it was somehow when tree roots actually pushed into your foundation!) 

I like to clean my windows just before I go away on hols and I am sure I would have noticed such a big crack along from the bay window. It was quite dramatic how it had suddenly manifested in the August after my 2 weeks holiday. (2018 hot summer). 

And then for about 2 weeks afterwards when I was home, I could actually hear things cracking when I was inside.  Then it seemed to come to an equilibrium and went quiet. 

friendam

Thankyou Annemos, definitely no cracking noticed during last insurers time or when I took out the policy with these in April. Oh well. Other than drains and trees I don't feel they are investigating it properly, during the conversation when they said tgey were closing the case  for reasons of exemption clause of drains gradual damage and wear and tear, google image proof of cracks before their policy start...mybimages don't show that there is...and then they said they don't think it is subsidence anyway even though they haven't instructed a structual engineer to look! I didn't get an answer to my Q of what is causing the main pencil wide crack mirrored noth sides of outer wall.

Annemos

As it is an Edwardian era house, it may be a good to bring in your own expert who has expertise in that era of property. 

Maybe other people will comment, too, after the weekend.