Insurers backtracking after claim validated

LaurenTsV

I contacted a claims handler at my insurers and they requested validation of the claim to green light alternative accommodation cover, as I was put out of home as a result of the claim. The claim at the time was not validated but subsequently has been this month with an offer (minus alternative accommodation compensation). I call up, pointing out the claim has now been validated and the claims handler was on the verge of actioning alternative accommodation cover with the only issue being validation.
I was able to receive the recordings of the 2 phone calls confirming this, with statements such as: 
 "i will be able to deal with the alternative accommodation side of it tomorrow for you, because i'll have that evidence there"
"it's not a case of this being the most horrible process - it really isn't. it's quite quick, but I just need that evidence to be able to enforce it."
"it's not that we can't, you know i mean with regards to the policy we will be able to utilise that absolutely, there is alternative accommodation cover in there. will you send me over a couple of photos. "

Is this worth following up with lawyers? Where do I start to find the appropriate representation?

DullGreyGuy

LaurenTsV said:

I contacted a claims handler at my insurers and they requested validation of the claim to green light alternative accommodation cover, as I was put out of home as a result of the claim. The claim at the time was not validated but subsequently has been this month with an offer (minus alternative accommodation compensation). I call up, pointing out the claim has now been validated and the claims handler was on the verge of actioning alternative accommodation cover with the only issue being validation.
I was able to receive the recordings of the 2 phone calls confirming this, with statements such as: 
 "i will be able to deal with the alternative accommodation side of it tomorrow for you, because i'll have that evidence there"
"it's not a case of this being the most horrible process - it really isn't. it's quite quick, but I just need that evidence to be able to enforce it."
"it's not that we can't, you know i mean with regards to the policy we will be able to utilise that absolutely, there is alternative accommodation cover in there. will you send me over a couple of photos. "

Is this worth following up with lawyers? Where do I start to find the appropriate representation?

Lets start from the beginning... this is presumably a Home insurance claim?

What happened to your home?

It sounds like you are getting a cash settlement for the damages to your property? Was that at your request or did they not offer to deal with the repairs?

Are you hoping they put you in Alternative Accommodation (AA) or that they settle as cash sum per the rest of the claim?

What was the rational on the latest call for not providing the AA?

Where are you currently living? At your damaged property or elsewhere?

I've never liked the term "validate your claim", always feels strange term to me. Really what they are doing is confirming there are no indemnity issues with your policy and then assessing the claim against the policy terms. As each section of the policy has different terms it's perfectly possible for a claim to be "validated" against one section but not against another. The classic example is in Motor insurance where the insurer may "validate" the claim for own vehicle damage but not against the courtesy car section, thats because the courtesy car section requires the vehicle to be repairable as no courtesy car is given if the vehicle is a total loss. 

Most people would not lawyer up to deal with an issue with their insurer. Instead they would follow the complaints process and, if necessary, escalate to the Financial Ombudsman if they are unhappy with the insurer's final response (or if more than 8 weeks pass). This process is free to you and the ombudsman is bound to find "fair" outcomes rather than the strict letter of the law. If you did decide to instruct lawyers then any claim under £10,000 would mean it's yours to pay their fees. Alternatively you could look at a Loss Assessor, basically the same people as a Loss Adjustor but employed by you rather than the insurance company, though if you are close to agreeing the bulk of the claim it may be too late to involve one. 

LaurenTsV

Yes home insurance.

*What happened to your home?*
This claim was for storm damage, that resulted in water damage and mould growth. I explained that the mould was causing respiratory issues and was living outside my home whilst they came (it took around 3 months for them to send their adjuster). The handler asked me to validate the claim at the end of Jan and she would begin sorting out accommodation cover. The day after she said she can't do that because the claim cannot be validated from what I've shown her.

*It sounds like you are getting a cash settlement for the damages to your property? Was that at your request or did they not offer to deal with the repairs?
My request via my assessor. The claim was then validated in April, but I have had to move because of the excessive respiratory issues and demand from the insurers that I cannot touch the damaged mould area, until it has been observed by them or the adjustor (it was eventually an adjustor).

*Are you hoping they put you in Alternative Accommodation (AA) or that they settle as cash sum per the rest of the claim?
Cash sum, like what they have now offered for damages on the claim, I have been out of home till now. Remembering the handlers call to action for me to validate, I called after validation, as they had at the time in Jan said they could begin the 'quick' process of dealing with my alternate accommodation (as I informed her of my medical visits and the fact I was no longer living in the property and was waiting for them)

*What was the rational on the latest call for not providing the AA?
The fact alternative accommodation was offered by the handler clearly on the 2 recorded conversations and was denied only by validating the claim, which was subsequently validated.

*Where are you currently living? At your damaged property or elsewhere?
Abroad. It was the cheapest option at a friends, as I waited for their adjustor. 

DullGreyGuy

LaurenTsV said:
*What was the rational on the latest call for not providing the AA?

The fact alternative accommodation was offered by the handler clearly on the 2 recorded conversations and was denied only by validating the claim, which was subsequently validated.

Sorry, dont follow your answer here... they are saying today that they won't cover AA because you declined AA earlier? Whereas your version of events is that they denied you AA because the claim was still under investigation?

Are you paying your friend for using their accommodation or is it just goodwill from them?

LaurenTsV

They offered alternative accommodation cover for a valid claim and were looking to begin the process.
Said that the claim had not been validated yet.
Asked me for photos. I sent photos. They said the ones I sent did not validate the claim.
I told them I can't wait around for them to come and assess the damage. They told me I have to wait.
I then left for my own health.
Assessor and adjustor dealt with the claim 2 months later (despite knowing I had to vacate the property). The claim was subsequently validated on the same grounds as discussed 2 months prior, and a fee for damages offered.
I then call saying the barrier to aa was the lack of validation .
They send me the calls which lay out the above.

It was on goodwill, but I had to pay for flights and also pay for alternative accommodation when I couldn't stay with my friend. I had weighed up the options and this was cheapest.
There was also a week prior to this where I had to pay for hotels around my house.

I feel my only options are either give it up if it seems pointless, talk to my assessor who dealt with the claim while I was away, or ombudsman.

Neither the assessor or the adjustor was made aware as the conversation was directly between the insurers and myself prior to them bringing onboard an adjustor and I was busy trying to deal with the practicalities of being out of house, with a claim that was seeking to get validated.

Do I contact the ombudsman through the insurers?

Thanks

DullGreyGuy

Follow the process as outlined in your policy book, it will say who a claims related complaint should be made to. You can't go to the Ombudsman until either you have received a Final Response/Deadlock letter/email from them or 8 weeks have passed since you logged the complaint, whichever is sooner.