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Insurance claim in a block of flats
DAK1
Posts: 3 Newbie
Our rented flat developed a leak in the bathroom that affected the flat below. It turned out to be failed sealant on the tiles at the back of the shower. As soon as we dicovered this, we immediately rang the insurance company (same company for our flat and the one below as per the lease). They confirmed that our flat/damage would NOT be covered (wear and tear) but the flat below would be able to claim. So, that is how we proceeded. We arranged for the tiles and sealant to be repaired immediately and the owners from the flat below put in their claim. The claim has now been rejected on the basis that the damage is not covered by any insurable peril. So my questions are: 1) why did they tell us that the flat below would be covered only to change their minds. The information given on the telephone was the same as the information included on the claim form 2) what is the point of having insurance if something like this is not covered? It must happen between flats all the time. The advice might be to change to a more fit for purpose insurer. We are not able to do this as the freeholder arranges cover on our behalf. We have no say whatsoever. So now, I am paying for my own repairs and for the repairs in the flat below and I am paying a premium of 480.00 pa for buliding insurance on a one bed flat.
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Comments
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This is quite standard in claims like this they need negligence on the part of you to pay the claim, it looks like there was non on your part.
Quite standard for cases like this, changing insurance companies is unlikely to change the outcome.0 -
ok... so you contacted the Block insurer of the Freeholder's policy not your contents insurance company?DAK1 said:Our rented flat developed a leak in the bathroom that affected the flat below. It turned out to be failed sealant on the tiles at the back of the shower. As soon as we dicovered this, we immediately rang the insurance company (same company for our flat and the one below as per the lease). They confirmed that our flat/damage would NOT be covered (wear and tear) but the flat below would be able to claim. So, that is how we proceeded. We arranged for the tiles and sealant to be repaired immediately and the owners from the flat below put in their claim. The claim has now been rejected on the basis that the damage is not covered by any insurable peril. So my questions are: 1) why did they tell us that the flat below would be covered only to change their minds. The information given on the telephone was the same as the information included on the claim form 2) what is the point of having insurance if something like this is not covered? It must happen between flats all the time. The advice might be to change to a more fit for purpose insurer. We are not able to do this as the freeholder arranges cover on our behalf. We have no say whatsoever. So now, I am paying for my own repairs and for the repairs in the flat below and I am paying a premium of 480.00 pa for buliding insurance on a one bed flat.
Assuming the above to be correct and ignoring the complexities of brokered business, MGA and all the other middlemen you may have made contact with rather than the actual insurer/ company with claims handling authority...
1) Most insurers have a dedicated First Notification of Loss team, it is the entry level member of staff where most claims handlers start their career before trying to move on to better things. As such they are both the least experienced staff and lowest trained. With IT systems and run of the mill enquiries they should make the right calls 99% of the time but errors can happen. This is more complex if you are dealing with intermediaries.
When I did Motor claims the FNOL team had to choose between 7 options for every accident claim:
1. No other vehicle involved
2. Third party hit policyholder in the rear
3. Third party pulled out into policyholder
4. Narrow lane collision/ Roundabout
5. Policyholder hit third party in the rear
6. Policyholder pulled out into third party
7. Other / Complex
Option 1 meant no technical team was assigned, 2 & 3 put it to "recoveries" who deal with getting the money back from the third party, 5 & 6 went to the "100% team" who deal with paying third parties when we are at fault and 4 & 6 went to the "Disputed Liability" team who decide what liability should be and either redirect it to Recoveries or 100% if clear or retain it if either there is a dispute or its split liability.
Can you guess what percentage went to Disputed? FNOL team are targetted on call times so rather than debate liability (they're untrained) they punted it to us. Sometimes policyholders insist and they didnt always give good advice.
2) Insurance is there to cover for unexpected events, something that "may" happen. Shower sealant/grouting breaking down overtime isn't a "may" happen, it's a known fact it will. Insurance is not a maintenance contract. It deals with the unexpected.
So looking at your Freeholder's building insurance, there is a maintenance/wear and tear issue and so there is no cover. It's one policy covering the whole building with one policyholder so resultant damage equally generally isn't covered. Occasionally you can sneak it in under Accident Damage but thats more likely with bad weather that isn't bad enough to be considered a Storm by the policy definition. So roof damage excluded but water damage subsequent can be AD. It comes down to the exact definitions and if you have AD cover.
@caprikid1 seems to be answering the alternative scenario which is your downstairs neighbour decides to try and sue you for the damage you have caused to their property by failing to maintain your property and therefore have been negligent. In this case it's debatable if this goes to the Buildings insurance that cover TP liability as the owner of the building or to your Contents insurance that covers TP liability as the occupier of the building.
Buildings - the freeholder doesn't have an obligation to maintain your shower so is likely to fail.
Contents - this has some potential merit but they'd need to show you had a duty to maintain the property as a renter and you had failed to take the steps a reasonable person would have... if there was a blinding big hole in the shower tray you'd been complaining to your neighbour about for years then they'd have a good case. Given the damage you did actually have? would need to see how obvious it was it had failed.0 -
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How was it your fault?DAK1 said:
If it was your fault then that's for your contents insurance0 -
DullGreyGuy said:
Apparently, it doesn't, even though the very experienced Insurance guy who I spoke to, initially said it would!DullGreyGuy said:0
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