House Insurance no fault claim - when we don't speak to everyone involved so you have to

seesawyoyo

This is actually a long ongoing no fault claim, where to solve seems to be at my own cost, is this just the way it is or with the insurance company to resolve. 

Brief summary: Housing association property next door (HA), with a water leak, eventually fixed, advised by HA surveyor to monitor for dry out for several months, they did not accept my offer to go in my house and view damage on my side, saying its an insurance issue. In that dry out time we saw other signs of water ingress 1.5 meters away from the source.

We reported this to the HA, and went though a long process of being ignored, eventually we received a reply by a deskside hunch from a photograph that the issue had already been fixed (i.e. the original fix). 

I raised with Legal Cover on the policy that the HA is not properly checking the repair - this took months with a conclusion from legal cover, even though the secondary source was 1.5m from the source, you have no proof its connected so they don't have to do anything. Do you have a survey to prove its not on your side. 

I said in response the law takes a view of am i being reasonable, I said I don't think in light of all this damage, and ongoing damage 1.5 meter away is unreasonable to ask them to verify this, so legal cover stuck to its position of not getting involved

The insurer at first said they will not get involved until the fault is fixed. through chasing this position the insurance claims team swung into action and a survey was carried out. The leak had then turned into wood rot by this time with a live infestation photographed on the HA side that then spread across to my property.

To cut a very long story short, a settled cost was presented but the responsibility to get the HA to fix the live wood rot at source is with [you] not us the insurer. I have not accepted what is in this settled offer

The legal cover was sent by me with the survey report, they then focused on probability that it could still be my side, the wood rot expert then wrote a new email removing all doubt its the HA. Legal cover then shifted, is not in the scope of legal cover?  - odd how that came out after gong down the survey route?  

Net result, 

• Insurer cannot settle with me, because there is a live fault and costs are not fixed, and the works wont warranty the work as the fault persists
• The insurer has instigated recovery from the HA insurance, through a 3rd party partner who I have conversed with who have accepted on the phone they have not actually (well the handler i was speaking to) recovered when there is a live fault before, and empathised that for them the costs continue to rise

To me this is stalemate, they cant settle or recover, and i cant fix the problem and the HA just operates in a culture of ignoring everyone. 

Should I transfer the settlement offer to me which is not enough into a holding account. at the moment its still with the Insurer.

I have conversed through every channel at the insurer including multiple letters to the CEO office - ignored from pillar to post or its just routed back to the same team.

The cost to fix Wood rot infestation requires specialist team, the HA as far as I would know, could send someone with a broom, I was ignored when this was a £2 washer fix, the cost at the moment is equivalent to a family car. or about a decade on rent for a HA tenant. 

How the insurer can simply settle and basically not have any care that this could re-infect the building

The HA insurer has been told its a live problem but the recovery firm is paid by my insurer who is refusing to share this letter, as its paid for by my insurance company. 

Happy there is settlement on table but the costs to get the HA to fix the repair and how to action that specific repair to specification is I am placing this as a insurance responsibility as i don't have funds to pursue this fix legally. in short the house insurer and its legal cover has in effect dumped us to solve the problem. but here is a settlement offer you cannot use because the problem is live, its like having a house fire repairing the roof while its still on fire

any views on this one, would be grateful


 

DullGreyGuy

I've always found LE cover on Home insurance to be very useful for an advice line but not so good on actually making a claim. Typically the advice side covers almost any legal matter whereas the claims side covers only a relatively narrow range of topics like trips & falls or employment law. 

What areas of law does you LE cover?
What grounds did they reject your claim?

Home insurance doesn't really have the concepts of "fault" and "non-fault" as where in motor about 1/3 of cases are non-fault in Home is too small a percentage to consider doing something about. 

Mark_d

You have evidence that there is wood rot infestation that is the HA's responsibility to fix.

Your legal insurer needs to bring a civil negligence claim against the housing association.

The claim against your home insurance, for damage to your property, should only be settled once the root issue is resolved.

You say your legal and home insurers have dumped this on you to solve.  I wouldn't accept this.  I would push back, being clear and precise as to what needs to happen.  If things still don't go your way maybe try to find a no win no fee law firm to take on this issue?  Then you can raise a claim with the financial ombudsman service against your legal insurer.

seesawyoyo

Mark_d said:

You have evidence that there is wood rot infestation that is the HA's responsibility to fix.

Your legal insurer needs to bring a civil negligence claim against the housing association.

The claim against your home insurance, for damage to your property, should only be settled once the root issue is resolved.

You say your legal and home insurers have dumped this on you to solve.  I wouldn't accept this.  I would push back, being clear and precise as to what needs to happen.  If things still don't go your way maybe try to find a no win no fee law firm to take on this issue?  Then you can raise a claim with the financial ombudsman service against your legal insurer.

Thanks buddy, 

Survey was done, which confirmed wood rot, that was a wood rot specialist, he went to the public area of the HA house photographed the source of it, right at the spot of the original leak, big pile of it. Also we have photographs when the original leak was reported, and no wood rot.

That didn't help the internal machine of the insurer get the source fixed at source to specification. That's the crucial bit, it has to be completed and surveyed by a specialist firm to specification, then the warranty gets applied, that's where the main cost is from. if that's not managed that could be a guy with a broom and a bucket of water for all i know 

The surveyor who mapped out the wood rot, had to write again to insurers legal cover help because in my opinion things seemed to be acting like Columbo's right hand helper, I felt like saying, you know for once it might be actually easier for the system to work on a solution rather than working on what you do not have to do.

For some reason the insurer has got itself in a right bad decision loop and cannot unwind itself. Does not actually make sense. It has also initiated recovery from the HA insurer, that operator said, its a bit unusual in my experience that we recovering a live fault, as the costs will rise, unfortunately they were not allowed to share the letter they sent for recovery which indicates its still live. As a firm i think they are actually working against themselves

Civil Negligence claim sounds like it, would you know if that would be from the Claims Team, The recovery Team, or the legal cover I have on the policy, there are so many entities involved. I should just be acting as the customer, There is no account level management who has stepped forward to act as an overall manager of this, the latest efforts has simply just been re-filed as a complaint. its being suppressed at the ground level. I will look at this angle though - thanks 

 

seesawyoyo

DullGreyGuy said:

I've always found LE cover on Home insurance to be very useful for an advice line but not so good on actually making a claim. Typically the advice side covers almost any legal matter whereas the claims side covers only a relatively narrow range of topics like trips & falls or employment law. 

What areas of law does you LE cover?
What grounds did they reject your claim?

Home insurance doesn't really have the concepts of "fault" and "non-fault" as where in motor about 1/3 of cases are non-fault in Home is too small a percentage to consider doing something about. 

Thanks for the info, interest about no fault - that feels like it to me, i get the feeling if they have a tick box do not recover costs someone would tick it

So it falls in several parts, a settled cost based on the estimate of damage has been provided, 75% of that work is contingent that the source wood rot is fixed to specification. 

The claim is accepted for the damage and that is covered. 

Where the Legal cover part in this was, I observed the original leak was not fixed and the HA ignored us for months on a request can they check it, and all I wanted legal to do was write to them to outline their duty of repair.

At this point in time, little would we know, if this was checked that would have been the end of it, we would have fixed the damage then moved on.

That disrepair continued to wood rot infestation which then added to the original costs of a small car. 

The legal cover a year ago said i had no evidence this on going disrepair was associated with the original fault (1.5m) away. Roll on months later we get the survey done, send it back to the Legal cover and we say ok now here is the proof its connected, and now they have a duty to repair this, and legal cover then shifted to its not covered, for them to get involved with a third party - this is an email its not like a legal letter that sets out the full position. Then the claims team have held the position from the very beginning we will settle the claim but fixing the source is your responsibility. No one can settle because the fault is unfixed. I have been through every channel in this firm, all channels lead back to claims. 

call me old fashioned but an insurance firm has slightly more levers to get a HA to fix a live fault than a policy holder who is put on ignore, in this case they have skin in the game, they cant close the case because no one can settle, stale mate.   

BarelySentientAI

seesawyoyo said:

call me old fashioned but an insurance firm has slightly more levers to get a HA to fix a live fault than a policy holder who is put on ignore, 

An insurance firm that is not the insurer of the HA has no more levers than you do.

DullGreyGuy

BarelySentientAI said:

seesawyoyo said:

call me old fashioned but an insurance firm has slightly more levers to get a HA to fix a live fault than a policy holder who is put on ignore, 

An insurance firm that is not the insurer of the HA has no more levers than you do.

Levers maybe but lets be honest... I receive two letters, one is basically written in crayon with bad spelling etc and the other is on headed letter paper from a Magic Circle law firm. Your office junior that receives the two, which do they respond to better?

I dont think the "solicitor letter" holds the weight it once did, especially with large organisations, but still they often elicit a more productive response. 

seesawyoyo

DullGreyGuy said:

BarelySentientAI said:

seesawyoyo said:

call me old fashioned but an insurance firm has slightly more levers to get a HA to fix a live fault than a policy holder who is put on ignore, 

An insurance firm that is not the insurer of the HA has no more levers than you do.

Levers maybe but lets be honest... I receive two letters, one is basically written in crayon with bad spelling etc and the other is on headed letter paper from a Magic Circle law firm. Your office junior that receives the two, which do they respond to better?

I dont think the "solicitor letter" holds the weight it once did, especially with large organisations, but still they often elicit a more productive response. 

You make sense Dullgreyguy,

From my simplistic view of the world, there is the funding aspect, going alone, its not exactly a bottomless pit, and for some its not even a pit, its more like a shallow plate.

As you say, how do corporates function generally and how does change happen, in my experience generally signalling no one out, to me it seems there are traffic lanes controlled by human auto bots for joe public, business decisions are made [once usually - or changes within the authorised band which is on a need to know basis], any challenge to that decision, the business deflects to the complaints process. To solve a problem you need a decision maker, not a qualified novelist. 

I seem to be having 2 battlefronts, one is none responding HA and the other is the Insurer who is not securing final settlement, based on a business decision to not resolve the underlying fault,. 

Is there levers to bring against the Insurer for failing to adequately settle? - (its on the table, but cannot be fixed)

and are there 

Levers against the HA, Local Authority, Housing Minister? but then they need letters that's been sent to the HA entity to which I am not allowed to be given a copy off.