At fault, despite not being at fault.

JonWal

I have recently had an appeal to the insurance ombudsman thrown out regarding my car insurance.

They have deemed that it is a "fair and reasonable" outcome for me to have an "at fault" claim added to my driver's history because a roof tile dislodged from my neighbour's roof and struck my car, whilst it was on my driveway and I was in bed.

Unfortunately, I scraped a post a year or so ago - my first genuine at fault accident in decades - so I now have 2 such fault claims against me within the last 2 years. Not only is this having a significant impact on the renewal premiums for mine and my wife's cars, but it has also prevented me from obtaining cover on my historic motor home.

Given that my appeal has been kicked out by the ombudsman - ostensibly because my insurers couldn't recover their costs, and not because of any blame on my part - is there any other line of appeal that I can pursue?

I'm doing everything that I can legally do to get my premiums down to something affordable, but as a driver of 30+ years experience and who has passed an advanced driving test, I'm struggling to see a way forward.

Any suggestions would be appreciated.

TELLIT01

It seems that 'at fault' is the situation where cost of the damage can't be recovered from a 3rd party.  If I'm right in my thinking, then the decision made by the Ombudsman was correct, if seemingly unfair.

BoGoF

At fault doesn't mean you are in any way to blame but, as you have diacovered, your insurer couldn't reclaim tbeir costs. It's just the way it is I'm afraid and you taking it to the Ombudsman was always going to fail.

The only other option would have been not to claim on your insurance.

400ixl

The term at fault means exactly what you have put, that your insurer could not recover their outlay. It is not as in you caused the accident.

Therefore everything seems to be in order on that front.

Is the reason they can't recover their costs because it was deemed to be a force majeure incident?

Aretnap

Insurers have always classified claims according to whether they recovered their costs from another party (which is a factual and objective way to classify them), not whether you were to blame for the incident (a rather nefarious and subjective classification - two people can easily have completely different opinions about who was to blame for an accident).

This concept is known as "fault" in insurance jargon because in most cases it does correspond to actual fault. Or at least, if someone else is to blame for an accident, and you can prove it, your insurer can usually recover their costs from the at fault person, or their insurer. However it does lead to some counterintuitive outcomes such as your car being stolen, or damaged by floodwater, or as you've discovered, being hit by a falling tile all counting as "fault" claims.

In the old days the use of this obscure jargon didn't really matter because insurance way always sold by intermediaries who understood the jargon and could explain it to the customer. Now that insurance is sold directly to the customer I agree that the term is misleading and insurers should use a ten like "accident, costs not recovered" instead of "accident, at fault". But ultimately that wouldn't be of much practical help to you - you'd still have a claim to report, and it would still be classified the same way and have the same effect on your premium.

Which is a long winded way of saying sorry, but the Ombudsman is right in this case.

JonWal

Thank you for all the comments and advice. I do agree that the terminology is misleading at best. I'd be (slightly) less upset if the claim was classified as "unrecovered" but I appreciate that the outcome would be the same.

Unless, of course, my neighbour's hadn't backed away and selfishly skulked behind the beurocracy. A sad way to destroy a decent friendship!

BoGoF

JonWal said:

Thank you for all the comments and advice. I do agree that the terminology is misleading at best. I'd be (slightly) less upset if the claim was classified as "unrecovered" but I appreciate that the outcome would be the same.

Unless, of course, my neighbour's hadn't backed away and selfishly skulked behind the beurocracy. A sad way to destroy a decent friendship!

Your neighbour is not at fault here unless he was negligent in some way in maintaining his property.

Another misconception is that a persons home insurance covers eventualities such as these.

35har1old

BoGoF said:

JonWal said:

Thank you for all the comments and advice. I do agree that the terminology is misleading at best. I'd be (slightly) less upset if the claim was classified as "unrecovered" but I appreciate that the outcome would be the same.

Unless, of course, my neighbour's hadn't backed away and selfishly skulked behind the beurocracy. A sad way to destroy a decent friendship!

Your neighbour is not at fault here unless he was negligent in some way in maintaining his property.

Another misconception is that a persons home insurance covers eventualities such as these.

If you imput the question if a car is hit by roof tile the answers that appear say that neighbour is liable and claim should be paid from the legal cover of the policy. Perhaps the neighbour didn't have legal cover.

user1977

35har1old said:

BoGoF said:

JonWal said:

Thank you for all the comments and advice. I do agree that the terminology is misleading at best. I'd be (slightly) less upset if the claim was classified as "unrecovered" but I appreciate that the outcome would be the same.

Unless, of course, my neighbour's hadn't backed away and selfishly skulked behind the beurocracy. A sad way to destroy a decent friendship!

Your neighbour is not at fault here unless he was negligent in some way in maintaining his property.

Another misconception is that a persons home insurance covers eventualities such as these.

If you imput the question if a car is hit by roof tile the answers that appear say that neighbour is liable

"Imput" the question where? On what legal basis is the neighbour liable?

DullGreyGuy

35har1old said:

BoGoF said:

JonWal said:

Thank you for all the comments and advice. I do agree that the terminology is misleading at best. I'd be (slightly) less upset if the claim was classified as "unrecovered" but I appreciate that the outcome would be the same.

Unless, of course, my neighbour's hadn't backed away and selfishly skulked behind the beurocracy. A sad way to destroy a decent friendship!

Your neighbour is not at fault here unless he was negligent in some way in maintaining his property.

Another misconception is that a persons home insurance covers eventualities such as these.

If you imput the question if a car is hit by roof tile the answers that appear say that neighbour is liable and claim should be paid from the legal cover of the policy. Perhaps the neighbour didn't have legal cover.

Thats wrong on both cases...

Its exceptionally rare that a neighbour is liable for what high winds do, to make that claim you either need to show they control the wind or that they were negligent in the maintenance of their roof... ie the roof has to be in an obvious bad state of repair and they've had ample time to effect repairs or they are God. 

If there was such evidence then the claim would be made from the neighbour themselves, they are presumably a home owner if you are saying they are responsible for roof maintenance and so should ultimately have the means to pay any claim. If they didnt want to pay it personally they could pass it to their Buildings Home Insurer who'd assist defending them and would payout any claim under the Public/Home Owners Liability section. 

Legal expenses cover is there to assist recovering uninsured losses from a third party... its even more unlikely the neighbour could use this as you suggest, this would be the neighbour suing the OP for their car damaging their tile.