Leasehold insurance for those with LPA responsibilities

noideapleasehelp

Hi Team

Advice required for not only me but anyone in the same situation.  My Mum went to a care home, and when I contacted her insurance company to update their records, was told her flat was no longer insurable

They told me because she wasn't there she needed unoccupied insurance.

I contacted online recommended link from original supplier, and was told that because Mum already had building insurance via her monthly service charge, she only needed contents insurance.

Small print of new company says you must visit property every week which I do. And when I visited last week, discovered that due to a massive water link from first floor property, Mum's ground florr property had pretty much been destroyed.  Ceilings due to water collection, had caved in on all rooms but bedroom, water pooling on all floor surfaces, had to switch off electrics as water was leaking through the ceiling light sockets.

I knocked on door of above flat, we went through her flat and couldn't see any obvious leaks but she shared she'd had new kitchen installed. We called her kitchen fitter who said - it's a "push valve issue" and stopped the leak.

So who do we contact to claim against?

Mum's insurance for contents only says - not us.
The owner of the flat above says nothing to do with me
The person who carried out the work says "I've registered but nothing to do with me".
I contacted service managers who Mum pays into buildings insurance and they say "nothing to do with us as the person who did stuff to the flat above is liable".

Who should we claim against?

And what should we do to notify parties in advance in writing of this claim?

Surely someone other than my Mum should pay for this damage?

But it seems that there's a legal loop hole and basically in my Mum's case - no one can be held responsible?

I'm so totally confused.  Her flat was supposed to go on sale this month because she is self-funding and although she has dementia, the local authority have said that they will not fund her until her flat is sold as they need the money from the sale of her flat to fund her nursing care.

My Mum and Dad worked so hard throughout their life to ensure that there was money left to pass on to their children and also that money came from my grandparents and their grandparents as a legacy to future generations, but now, because Mum has dementia and it's not recognised by this government as a brain disease, all of Mum's money will go for her care.

Her care home fees in a place outside of London is £89k per year.

That alone is just horrible.  But now her flat is unsalable, I've been told by the local council that if I cannot pay my Mum's care home fees because I can't sell her flat, that they will move her to a "cheaper" care home and that we as a family will have no say where they place my Mum.

Because Mum has dementia, we researched carefully all the care homes in our area so that we could ensure that Mum would always be safe and that whatever care home she went to would get to know here before her dementia really took hold and knowing her would have a relationship and care about her.

Now the Council are telling me, that it doesn't matter about that, as they will place Mum wherever they want, and the people that have looked after and love her for the last 6 years, will not feature in Mum's care.  

It was hard to swallow that Mum's care would be £85k per year but we thought that at least she would always be cared for by the care home we chose, and the staff would always know her such that when her final days with dementia hit home, they knew her and loved her the way we do.

Never mind the insurance issue on her flat, I'm just left confused how all of this works.  So Council have already laid claim before we've sold Mum's flat to £200k for her care.  Her flat is only worth £133k.  

I'm sure there are others on this forum facing this.

It doesn't make sense.

Martin -- you must help us on this please!!!!

elsien

Please can I check whether you are wanting advice on the insurance issue, or the funding issue, or both? 

With regards to care home funding and presuming she doesn’t qualify for full health funding? It’s not to do with whether dementia is considered a brain disease or not, it’s whether her needs are complex enough to count as health needs. Many people with dementia needs support with continence, washing, eating et cetera but those are all social care needs. And we don’t have a joined up health and social care system because it’s an issue that no government wants to tackle so they keep kicking it further down the line. 

elsien

If/when your mum‘s funds run out then the local authority will have to fund instead and they are facing funding crises.
So the options will depend on what the gap is between the care home that you have chosen, and what the local authority would normally pay.
If the gap is not too big, then family can pay a third-party top up if they are willing and able to do so and sometimes the care home will agree to reduce their rate to allow the person to stay.

There have been  judicial reviews where the outcome has been councils are permitted to take  funding into account in making decisions. So if the current care  home is too expensive, then yes they can lawfully make a decision that your mum needs to move somewhere cheaper. 

 But it still has to be a best interests decision in line with the mental capacity act, and they have to evidence that anywhere they move her to can meet her assessed needs. And they still have to take best interests into account such as family being close enough to maintain contact. so if you can show that cheaper homes can’t meet her needs the local authority would have to pay a higher rate. That’s the point which you would really need expert advice.
This is an example of where someone challenged a decision and won. 

https://www.lgo.org.uk/information-centre/news/2020/nov/council-told-woman-with-dementia-to-change-care-home-when-her-money-ran-out

However for context, I’m in the Midlands and the local authority rate is about £350 a week for residential rather than  nursing care and they will go up an extra hundred pounds if pushed. There’s no way they’d be paying 86K. 

it is not a good system. But it’s not going change any time soon.
i’m presuming that you’ve tried for CHC funding and not been awarded it? 

noideapleasehelp

Hi All

This is most definitely about who do we contact regarding Mum's insurance and how to claim for the damage done to her flat caused by the upstairs property as a result of a kitchen new kitchen being installed and the kitchen fitter having done something to cause the damage.

Thank you so much for those who've seen this thread and also replied about Mum's care home fees.  That really useful information, but primarily I need advice about the insurance issue.  My bad for muddling things on this thread.

I've had to take my Mum's property off the market because of this leak and insurance issue.

And I've mentioned Mum's care home funding because if I can't sell her property, because of this leak issue it will impact her further down the line.

So very much hoping someone can understand this leasehold issue and who claims what to help me understand who is responsible as at the moment everyone is saying it's not us, but surely someone in this situation is responsible?

eddddy

noideapleasehelp said:

This is most definitely about who do we contact regarding Mum's insurance and how to claim for the damage done to her flat caused by the upstairs property as a result of a kitchen new kitchen being installed and the kitchen fitter having done something to cause the damage.

You need to check your mum's lease, but usually with flats, the freeholder is responsible for arranging buildings insurance.  So you can potentially claim on that.

Freeholders often use a Managing Agent to deal with everything - I suspect that's the people you are referring to as Service Managers. So they would be the people to make an insurance claim.

But...

• Most building insurance policies exclude losses resulting from poor workmanship and poor materials - so the insurers might refuse the claim on that basis.

• You also need to check the buildings insurance policy for conditions relating to unoccupied properties

So... if the insurers won't pay out, it would then be a claim against the kitchen installers for negligence.

But sometimes an insurance company will pay the claim anyway, and then they will chase the kitchen installers to get their money back.

So perhaps the next steps are...

• Contact the kitchen insurers saying that you believe they were negligent - and see how they respond

• And/or insist that the Service Managers make an insurance claim - and see what the insurers say. (The downside of this is that even if they refuse to pay out, it will increase everyone's contribution to the cost of insurance.)

ThisIsWeird

Hi niphm.
What a horrifying situation for you.
Which insurance covers the repair to the fabric of your mum's flat? The buildings insurance, which is compulsory and to which your mum has always contributed. That is the responsibility of the Freeholder, and it appears they may have advised you incorrectly.
There is an exception to this, tho', and that if someone has been 'negligent', so the other person in the frame is the professional kitchen installer. But, 'negligence' would have to be shown - 'proven'. Eg, if he made all the plumbing connections correctly, following the the manufacturer's guidelines, and one then failed, then he wouldn't usually be 'liable'. However, if he failed to make a proper connection - surprisingly easy to do - and didn't carry out expected double-checks, then he 'could' possibly be deemed negligent. In which case, his insurance should cover it.
What you would hope would occur in such cases is that the Freehold insurance takes it on, but the insurance co then sees if it can claim off the installer. Think of it as a car accident for which you were not to blame, but the third party doesn't admit liability either; your insurance would initially pay to fix your car, but will then try and chase the other party with the evidence they have of the true cause.
The Q here is - how do you oblige the Freeholder to do the right thing? I'm not sure what the answer is - is there a management group in place?
All you can say to them is that it almost certainly was as a result of the kitchen installation, but that you are in no position to say the person was 'negligent' - it's not your call to make.
Did your mum have separate 'contents' insurance? If not, then I'm sorry to say that all loose items and flooring in her flat are unlikely to be covered; carpets, TV, beds, clothes, free-standing wardrobes, etc. if any of that is damaged, then it would have been covered by her 'contents' policy.
The only exception I know of is if she (you) can demonstrate that the kitchen fitter was negligent, and then their Liability Insurance policy would/should cover it again.

So, what to do?
1) Tackle the building management co and make it clear that the 'fabric' of the building is covered by their buildings policy. Ask how to make a claim. If your mum doesn't have a copy of this policy, ask for one and read it - see how to set a claim in process. Don't take "it was the fitter" as an excuse - tell them it's their insurance co's responsibility to tackle that and reclaim of them if they think they have a case.
2) Speak to your neighb and make it clear they have no personal responsibility, but that you may need to claim off their fitter - can they describe what, exactly, the cause was? What is a "push valve issue"?! (In short, unless this was a correctly-installed fitting that failed, then it 'must' have been installed incorrectly, so the fitter is liable. Whether he is also 'negligent', is the tricky part. 
3) If your mum does have contents insurance, then contact them to begin a claim. They should send out an assessor. This will not cover the 'fabric' - the ceilings, walls, fitted kitchen, (probably), doors, etc.
4) If you do have contents, ask them for advice on how to oblige the Freeholder to act.
5) Call up CAB - ask them, too, how to force the FH to take responsibility.

In all of this, explain the urgency of having it sorted for your mum - her medical condition, and the risk of her losing her chosen care home.
Do not bother mentioning other emotive issues such as how hard they worked all their lives (tho' I'm sure they did) or their wish to leave a legacy (I'm sure they did, but no-one is entitled to this, and her care is all that matters).
5) I don't know - others may advise - if it's worth even tackling the kitten fitter, and explain your mum's awful dilemma, and - if they can acknowledge that they were, to some degree, negligent, eg they really should have double-checked the security of all the fittings, etc., - then making a claim off their EL insurance would be the 'right' thing to do. Once all this is sorted, an honest review will be written.

ThisIsWeird

noideapleasehelp said:

My Mum went to a care home, and when I contacted her insurance company to update their records, was told her flat was no longer insurable.
They told me because she wasn't there she needed unoccupied insurance.

I contacted online recommended link from original supplier, and was told that because Mum already had building insurance via her monthly service charge, she only needed contents insurance.

Small print of new company says you must visit property every week which I do.
So who do we contact to claim against?

Mum's insurance for contents only says - not us.

Looking at this again on my PC, niph, some things appear more clear.

CONTENTS insurance: your mum has always had this, and you did the right thing in informing them your mum had moved into a home, they pointed you to a different policy/provider that includes 'unoccupied', a condition being that you visited at least once per week - which you did - and there is now a claim for all the 'contents' damage (carpets, flooring, appliances, decorating, etc)?

I cannot see any way that they can refuse to cover the contents that have been damaged.

Then there's the 'fabric' of the flat. This is (should be...) covered by the Freeholder's buildings insurance. It is not for you to prove negligence by anyone - how can you possibly do that?! The insurance company's assessor or investigator will be interested in the 'cause', tho', and it's up to them to chase the kitchen fitter if they think they have a chance of re-claiming of their insurance instead.

If the FH tries the "the flat was unoccupied" angle, you can inform them that you have attended at least once per week as required by your mum's contents insurance provider. All policies allow a certain level of absence, just for folk going away on hols, and working away from home for periods, etc, and this is typically for a few weeks - 30 days or so? Your mum's flat has been attended far more frequently than this. You caught this ongoing damage within a week; your mum could have been away for a month at any time during her tenure when this could have happened.

These insurance companies are seemingly behaving without integrity, hoping to just pass the buck.

The Q is - how do you oblige them to act? I don't know. Perhaps phone CAB - keep the facts as brief and simple as you can, perhaps as outlined above (assuming it is correct). 

Each Insurance Co will also have a complaints procedure - find out what it is (get copies of both policies). And ultimately an ombudsman - but you'll have had to exhaust the complaints procedure first.

I don't suppose she added Legal Protection to her contents policy? If she has, call them up for guidance - they are (should be) independent of the ins co.

From what you say, I think your mum should be covered for both build and content.

Can I ask you to find out - precisely - what reason each insurance co gives for not covering this? Your mum's Contents provider - what do they actual 'say' when you point out that this policy is one you took out as your mum was no longer living in her flat? And that you have completely fulfilled your obligations to visit at least once per week? If it's a fob-off, or if they claim it's your responsibility to tackle the kitchen fitter, make it clear that you do not KNOW what the cause was, whether or not it may constitute 'negligence', and you are in no position to carry out such an investigation - that's not your task to do. If they maintain otherwise, ask for their full name, and ask them to confirm that the call is being recorded. Mention the time, and date - you'll be writing this down - and tell them you'll be making an 'official complaint'.

What else to try? Some newspapers have consumer champions who will investigate certain issues, but I suspect that could be a slow process. One is the Telegraph ( https://www.telegraph.co.uk/money/katie-investigates/katie-morley-investigates-contact-form/ ). Any local papers who might like a 'human interest' story?

And there is always your MP (who will most likely be fighting for their political life :-) )

In any correspondence, keep this as unemotive as you can (whilst still making it clear that it is very distressing since your unwell mum could be moved from her chosen care home as a result), as brief as you can with the facts as key points as much as possible, and also that you totally believe that you (and your mum) have fulfilled your obligations to the insurance companies in every way.

If you haven't done so, it may be worth writing out a succinct outline of the key events first - things can become very involved, so you want to be able to refer to the facts as quickly and succinctly as possible:

20th Dec 2023 - mum went into X care home because of...

Xth Dec 2023 - I contacted her insurance company ('contents' to explain, they advised xyz, which we did. A condition was for minimum weekly visits, which I carried out accordingly.

Yth January 2023 - discovered flat was flooded... etc etc.

Add to this as things develop, eg Zth Jan 2023 - contacted Freeholder (name...) who said "Now't to do with us..."

noideapleasehelp

Thank you so much all of you who have posted a reply.  Thank you too for doing it so quickly.
My apologies that I was not in the right head-space when I posted so put emotional content in regarding my Mum's situation which resulted in confusion. 
elsien - thank you for your post regarding Mum's care, etc, I'll be following-up on your links!
eddddy and ThisIsWierd - thank you for your posts regarding the insurance angle.  Your replies are exactly what I need to take forward and also for the kind reminder that I need to keep the "emotional" content out of correspondence with insurers.
Yes, ThisIsWeird, contents insurance does include legal cover, but at this point the insurance company have suggested that as the damage has been done to the fabric of the flat, and her insurance is contents insurance (no, there is no building insurance on the policy as I thought that was covered by her monthly service charge contribution for buildings insurance) they cannot help in the first instance although damage to contents i.e. carpets, electric radiators, lighting, flooring etc has been done, but once I link in with whoever and whatever their insurance company is, they are then happy to help further with claims for carpet etc against the appropriate person and their insurance company.
Yes, Mum is paying monthly to a Service Management company who take out the buildings insurance on behalf of the leaseholders of the flats.  I contacted them first and was told that they will not contact their insurance company on Mum's behalf because it's not actually an issue with the fabric of the building as it's an issue caused by the leaseholder of the flat who engaged the kitchen fitter.
The leaseholder of the flat has refused to engage regarding insurance, and all communication has been only verbal. They are saying that is not their problem and they will not contact their insurance company because it is an issue with the kitchen fitter.  Maybe this is important, I have never sent any written/email correspondence to the leaseholder of the flat.  Should I have done this formally in writing?  From my perspective, I've not sent formal letters to them etc because the moment I went into Mum's flat and thought it was coming from the flat above, they kindly let me in and allowed me to go through their bathroom and kitchen to see if there was an obvious leak they could see.  They could have refused me, but they didn't, and also explained they'd got a new kitchen fitted and gave me the mobile number and name of the person who had done the work, which meant I contacted the fitter, and the leak got stopped with their help within a couple of hours. 
The kitchen fitter remedied the problem, told me that it was something to do with a push-valve but that is all I know.  As suggested, I'm not in a position to understand what that means and implications. The kitchen fitter said they would contact their insurance company to let them know about the issue.  And I understand that was done.  The kitchen-fitter's insurance company has acknowledged they have received a registration of the issue but that there has been no further communication with the kitchen fitter on the claim, so have said without the kitchen fitter's co-operation on the claim, they cannot process it or take it forward.
My understanding is that whilst the kitchen fitter has shared with me that this push-valve was the issue and remedied it, he has not directly claimed liability.  Again, this is all verbal communication although a letter was written on Mum's behalf saying, thanks for sorting out the leak but we now need to work to take this forward with your insurance company. I've never received any communication since.  I found out the insurance company because all works by leaseholders have to go through Service Management company and they have info on insurance liability for work carried out.  
So that's where I am on all of this.  I'm very confused how insurance companies all work with this type of "chain", and who claims through what insurance company but also who should I work through on behalf of Mum for this "chain" to be enacted on her behalf when it seems all bits of the chain are suggesting, it's not their issue to take forward.
In the meantime, I'm incurring costs being paid by Mum on her behalf. 
When I walked into the flat it smelt awful with condensation on the double-glazed windows (not previously there), I guessed it's water in the atmosphere and I needed to get a dehumidifier in.  But first step was switch off electrics as water was coming through the light fittings.  After the leak was stopped, I employed an electrician to check the electrics to ensure I could switch back on to run a dehumidifier.  I've hired a professional dehumidifier on a weekly basis, and I have a family member going in each day to empty it.  I got all the damaged furniture moved to another part of the flat.  I had also arranged when Mum went into care for a plumber to go in and switch off the water supply in the flat to avoid pipe leaks etc.  I'm not really a clever person on all of this stuff, but I think I've done the right thing, but on Mum's behalf I'm incurring costs including electrics without anyone to claim against, but I'm keeping a record. At some point I'm hoping that these costs Mum's incurring, which are protecting her flat, will be reimbursed.  But I could be wrong.
You've all kindly given me links and where I can take this next and I am so grateful for your replies.
So if the kitchen fitter doesn't engage with their insurance company and they say they can't take it forward, I'm confused as to what I do next.  
Yes, I'll reach-out to CAB, but I'm guessing that at this point, if the kitchen fitter doesn't engage with their insurance company and all other insurance companies can't act until that is done  ... I'm at an impasse.  There is no-one I can reach-out regarding insurance companies involved to help me push this through for Mum.
I don't want to spend her money on solicitors, but is that where I am now?
I'm so sorry to call on you all again, but can you guide me again please?
My apologies for taking up your time, and I very much hope this post helps others in the same situation.  Before posting I did go through all previous posts of a similar nature on this site, but my situation seems to be different.
Again my very grateful thanks to you all for your help.  And just to say, you are absolutely stars!
All the best.






  
 

 

ThisIsWeird

Awful. This just shouldn't be like this.
When an underfloor pipe in my bro's flat burst and brought down the ceiling in the flat below, the FH (a git in most respects) sent his plumber who ID'd a fractured copper pipe - so no-one at fault - fixed it, got his builders in to fix the ceiling, and the Leaseholder called on their contents insurance to sort any damaged belongings. My bro had to do now't. That's how it should be (unless someone has messed up and caused the leak by being negligent).
Ok, your mum has LP included in her contents policy. They SHOULD be guiding you now, telling you exactly what steps to take, helping you to formulate letters and correspondence, and ultimately being prepared to take action against the FH's recalcitrant Buildings insurer. 
This is shameful.

All I believe I can add at the moment is that your upstairs neighb has no liability whatsoever. The kitchen fitter might be, if they have been careless/negligent, but it would be very hard to prove, and it's not your job to do so.
The building management company need a metaphoric kick utbs - how dare they shirk their responsibility.
That is my take on this, but I'm pretty confident it's (largely...) correct, but your LP should now be acting for you - this is exactly what it's for (read what they cover). 
The LP is usually completely independent of the contents insurance co, and simply act for YOU. Use them to guide your buildings claim. At the same time - but completely separately - put together your contents claim to your mum's insurer.
Good luck.

eddddy

Just to re-summarise..

You have 2 routes to follow...

• 1) A Claim for negligence against the kitchen fitter 

• 2) A claim for "damage caused by escape of water" on your freeholder's buildings insurance policy
  

I suspect that claiming against the kitchen fitter will be a hard fight.

I suspect that persuading the Service Management company to make a claim on the Freeholder's buildings insurance policy might be a bit easier.


When contacting the Service Management company, I'd suggest that you keep everything brief and to the point. For example...

"I wish to claim on the buildings insurance policy for 'damage caused by escape of water'.

You suggested that I should approach a kitchen fitter who worked upstairs first. I have done so, and he denies responsibility for the damage."


Adding other information might just cause confusion.

If the Service Management Company still refuse to act, you can write to the insurance company - as described here: 
https://www.lease-advice.org/template-document/notice-potential-claim-leasehold-insurer-section-30a-paragraph-7-schedule-landlord-tenant-act-1985/

ThisIsWeird

Thanks Eddddy.