In limbo with our insurance company

System

This discussion was created from comments split from: House Insurance Issue - I'm not sure if it's covered.

hairtearer

Need professional, independent insurance advice but the FOS service only deals with complaints.

We are in limbo with an insurance company.  Our insurer accepts, in writing, they are liable to pay for substantial damage to our house but have not paid us, 6 months on. We have met our end, submitted costs, details, reports etc and have had to pay for repairs to make house safe and watertight.  

I want to cancel insurance, to find another insurer,  because they made a mistake on the policy and will not update it but I cannot go elsewhere as I do not know where we stand with this claim or our status, or even if it is a claim, as they accept liability outside the insurance cover.  No useful responses from the insurer.  If we leave them before this is settled is that still considered to be an outstanding claim etc.

Cannot find anyone in the insurance industry to answer questions about this, to work through this problem.

I need to be honest when I speak to the next insurance company to take out a policy when they ask if we have made any claims and similar questions.

 The insurers have messed up on this and continue to cause us costly and worrying problems, I am concerned we are not insured and have nowhere to go with this. We lose out in all directions.

Thanks to all those who have a view (everyone does). If anyone has resolved a similar experience I am interested in your views.  We are looking for a person or organisation who has a professional, independent insurance background to either point us in the right direction for next steps or advise us.  

DullGreyGuy

hairtearer said:

Need professional, independent insurance advice but the FOS service only deals with complaints.

We are in limbo with an insurance company.  Our insurer accepts, in writing, they are liable to pay for substantial damage to our house but have not paid us, 6 months on. We have met our end, submitted costs, details, reports etc and have had to pay for repairs to make house safe and watertight.  

I want to cancel insurance, to find another insurer,  because they made a mistake on the policy and will not update it but I cannot go elsewhere as I do not know where we stand with this claim or our status, or even if it is a claim, as they accept liability outside the insurance cover.  No useful responses from the insurer.  If we leave them before this is settled is that still considered to be an outstanding claim etc.

Cannot find anyone in the insurance industry to answer questions about this, to work through this problem.

I need to be honest when I speak to the next insurance company to take out a policy when they ask if we have made any claims and similar questions.

 The insurers have messed up on this and continue to cause us costly and worrying problems, I am concerned we are not insured and have nowhere to go with this. We lose out in all directions.

Thanks to all those who have a view (everyone does). If anyone has resolved a similar experience I am interested in your views.  We are looking for a person or organisation who has a professional, independent insurance background to either point us in the right direction for next steps or advise us.  

You could hire a loss assessor? They are basically the same as a loss adjustor other than they are employed by the policyholder rather than the insurance company. 

You are free to move to another insurer at renewal, policies are written on a "losses occurring during" basis and in principle it won't impact the outcome of the claim if you do; though it may impact any goodwill they may consider giving you. At present you would need to declare it as an open unsettled claim, which may notably reduce the number of insurers interested in insuring you. In principle as long as all the works have been done and its just a reimbursement question then more should be willing to cover you. 

Obviously you could post the details here, or better on your own thread, and people here could either share their personal and/or professional experience. 

hairtearer

Thank you for your response. Not sure what your experience is DullGreyGuy.

I am looking for an independent insurance advisor to discuss this. I am prepared to pay for the right professional service but cannot find anyone who has no vested interest in insurance. This is not a loss adjuster issue, the insurer accepts they made a mistake and it is their mistake. We cannot move forward without advice.  I do not want to disclose details in this thread.

born_again

hairtearer said:

Thank you for your response. Not sure what your experience is DullGreyGuy.

I am looking for an independent insurance advisor to discuss this. I am prepared to pay for the right professional service but cannot find anyone who has no vested interest in insurance. This is not a loss adjuster issue, the insurer accepts they made a mistake and it is their mistake. We cannot move forward without advice.  I do not want to disclose details in this thread.

So given that & you are getting anywhere with the ins co, then a complaint & FOS if not resolved is the way forward.

Not sure why you think a independent who has no vested interest is going to be the best option. Clearly who ever you get would need to fully understand insurance. Therefor would have had to work in the industry. 

Basically a independent insurance advisor is a broker. Of which there are many out there. Just how they would be able to help with your current claim issue is a different matter 🤷‍♀️

DullGreyGuy

hairtearer said:

Thank you for your response. Not sure what your experience is DullGreyGuy.

I am looking for an independent insurance advisor to discuss this. I am prepared to pay for the right professional service but cannot find anyone who has no vested interest in insurance. This is not a loss adjuster issue, the insurer accepts they made a mistake and it is their mistake. We cannot move forward without advice.  I do not want to disclose details in this thread.

I've worked in insurance for decades and started my life in Claims, though mainly Motor, but have worked for a small insurer where your fingers are in many pies. For the last 15 years though I work at a more strategic level  on a freelance basis and often more in corporate insurance than personal lines but have occasion helped a client with something in the PL space.  Whilst I can provide my opinion to insurance firms I am not licensed to advise individual customers. I do frequently share an opinion on here on various insurance matters. 

A Loss Assessor is the normal place to go for assistance with claims, as mentioned in the prior post. Some may be conflicted because they work for certain insurers as a loss adjuster too but this is a normal thing that can be managed. 

born_again said:
Basically a independent insurance advisor is a broker. Of which there are many out there. Just how they would be able to help with your current claim issue is a different matter 🤷‍♀️

Brokers in the personal lines space are often non-advisory, there just isnt enough margin for all the extra paperwork required for advised sales unless you are looking at high net worth or some exceptional niche. 

They would typically only give claims advice if they sold you the policy but they too can have a conflict of interests if their terms of business with the insurer includes some form of profit share and so they'd be incentivised to say things that minimise the value of the claim. 

born_again said:

hairtearer said:

Thank you for your response. Not sure what your experience is DullGreyGuy.

I am looking for an independent insurance advisor to discuss this. I am prepared to pay for the right professional service but cannot find anyone who has no vested interest in insurance. This is not a loss adjuster issue, the insurer accepts they made a mistake and it is their mistake. We cannot move forward without advice.  I do not want to disclose details in this thread.

So given that & you are getting anywhere with the ins co, then a complaint & FOS if not resolved is the way forward.

Not sure why you think a independent who has no vested interest is going to be the best option. Clearly who ever you get would need to fully understand insurance. Therefor would have had to work in the industry. 

A complaint maybe the best option but depending on the problem and the roadblock the OP may not be able to articulate it well or may have wrong expectations - not enough detail has been given to be able to say. 

Ultimately insurances are contracts and so there is always the legal option; they may lack knowledge on what standard industry practice is but they can interpret a contract well, depending on the problem. In some areas of insurance claims rely heavily on lawyers, in some areas all the claims handlers are qualified lawyers (though not mass market consumer insurance).