Insurance Claim - Complaint

someday_maybe

Looking for advice/support! 

Child flooded the bathroom from the sink, with water ingress downstairs. I have accidental cover which includes this scenario. I was woken at 3am to the situation. I removed the bath panel and partially lifted one plank of bathroom flooring to start the drying. In removing the bath panel, I've damaged the bath sealant (panel was attached to batonning).

Insurance sent out two companies who arrived on the same day, about 3 hrs apart. First arrived to assess damage, second collected policy excess, ripped out flooring/skirting/etc and left fans/dehumidifiers.

Fast forward a week and the claim has been rejected because the sealant is damaged. I had explained to the damage assessor why it was damaged etc but obviously this has been ignored as it gives them a great get out.

The damage downstairs clearly demonstrates that it wasn't a bath overflow issue as has been alleged. The bathtub sits directly above the downstairs WC, with the sealant edges sharing the same 3 walls of the WC. The damage in the downstairs WC is only on one wall, this being the one closest to the sink which overflowed (water has gone under the bath panel). The wall between the top of the bath and the bathroom floor is dry. The floor under the bath is only wet at the end closest to the sink. Damp readings in the floor under the sink and under the bath adjacent to the sink are almost identical. All corroborated in the photos taken by the assessor.

Downstairs WC ceiling and walls are not overly damp, mostly water marked. 

The downstairs hallway however is far wetter. The door lintel above the front door has the highest damp reading on the left hand side - the furthest point from the bath that damage has occurred and crucially, sits under the sink. The flooring around the front door is most water damaged, again the left hand side, furthest from the bath,  wetter than the right, sitting under the sink. All corroborated in photos taken by the assessor and submitted with their report. 

The second company in have ripped up flooring in all 3 areas, leaving bear concrete/screed and chipboard upstairs to dry. 

Obviously I will be complaining, so really looking for any advice on what to include to support the blindingly obvious fact that water can not defy the laws of physics and move from the alleged bath overflow to a spot under the sink leaving no trace. 
Also exceedingly annoyed that the flooring has all been ripped up leaving no option to replace in part if I end up having to foot the bill. The ground floor is continuous flooring of c50m2! 

born_again

someday_maybe said:

Looking for advice/support! 

Child flooded the bathroom from the sink, with water ingress downstairs. I have accidental cover which includes this scenario. I was woken at 3am to the situation. I removed the bath panel and partially lifted one plank of bathroom flooring to start the drying. In removing the bath panel, I've damaged the bath sealant (panel was attached to batonning).

Insurance sent out two companies who arrived on the same day, about 3 hrs apart. First arrived to assess damage, second collected policy excess, ripped out flooring/skirting/etc and left fans/dehumidifiers.

Fast forward a week and the claim has been rejected because the sealant is damaged. I had explained to the damage assessor why it was damaged etc but obviously this has been ignored as it gives them a great get out.

The damage downstairs clearly demonstrates that it wasn't a bath overflow issue as has been alleged. The bathtub sits directly above the downstairs WC, with the sealant edges sharing the same 3 walls of the WC. The damage in the downstairs WC is only on one wall, this being the one closest to the sink which overflowed (water has gone under the bath panel). The wall between the top of the bath and the bathroom floor is dry. The floor under the bath is only wet at the end closest to the sink. Damp readings in the floor under the sink and under the bath adjacent to the sink are almost identical. All corroborated in the photos taken by the assessor.

Downstairs WC ceiling and walls are not overly damp, mostly water marked. 

The downstairs hallway however is far wetter. The door lintel above the front door has the highest damp reading on the left hand side - the furthest point from the bath that damage has occurred and crucially, sits under the sink. The flooring around the front door is most water damaged, again the left hand side, furthest from the bath,  wetter than the right, sitting under the sink. All corroborated in photos taken by the assessor and submitted with their report. 

The second company in have ripped up flooring in all 3 areas, leaving bear concrete/screed and chipboard upstairs to dry. 

Obviously I will be complaining, so really looking for any advice on what to include to support the blindingly obvious fact that water can not defy the laws of physics and move from the alleged bath overflow to a spot under the sink leaving no trace. 
Also exceedingly annoyed that the flooring has all been ripped up leaving no option to replace in part if I end up having to foot the bill. The ground floor is continuous flooring of c50m2! 

A 3rd party collecting the excess?

Just file a complaint with the insurance company. You can either phone them & do it or via the address they will have on their website section for complaints.

someday_maybe

Thanks @born_again.

Yes the 3rd party collected the excess - the insurance company letter states "Your policy excess is £300. XX company Limited will collect this from you as we’ve asked them to manage your claim".

They are not the same party who've decided to refuse the claim though? 

Does the complaint need to go to the insurance company, the 3rd party who collected the excess, the 3rd party who've decided to refuse the claim or all/some of those? 

I've SAR'd the 3rd party assessing/refusing the claim already today as I don't have a copy of their report even. The section on the portal they use for 'outcome' has had a blank image uploaded instead. I'm pretty convinced that the report will be missing the specifics! 

born_again

Complain to Ins co. They are regulated, so if you do not agree you can take it to FOS.

DullGreyGuy

born_again said:
A 3rd party collecting the excess?

Its common for a contractor to collect the excess, there is no point the insurer collecting it, paying card fees, and then having to hand it over to the contractor when they can just bill the insurer less the excess and get the excess directly from the insured and be the ones that pay fees. 

born_again said:

Complain to Ins co. They are regulated, so if you do not agree you can take it to FOS.

Claims management firms are too, after all many act will full delegated authority or such authority up to claims of £100,000 or more. If they dont then the insurer has to pay VAT on the services which like banks most insurers can recover very little VAT as they sell exempt goods. 

someday_maybe said:

Does the complaint need to go to the insurance company, the 3rd party who collected the excess, the 3rd party who've decided to refuse the claim or all/some of those? 

I've SAR'd the 3rd party assessing/refusing the claim already today as I don't have a copy of their report even. The section on the portal they use for 'outcome' has had a blank image uploaded instead. I'm pretty convinced that the report will be missing the specifics! 

It's always best to follow the complaints process as outlined in your policy book which in some cases may be different for claims than it is for non-claims situations. You may find the complaint gets handed over to the company managing the claim to deal with.