Insurance company refusing claim

christophercharles

Hi

I really need some help. I live in my parents house to care for them. This is the first time ive had to deal with the home insurance company as previously me Dad did it but he cant anymore. 

Basically, we had 2 blocked bathrooms (toilet, shower+sink) with water almost overflowing when we used any of it and drain gulleys overflowing. It was urgently in need of a blockage so i called a drain company. They identified that the problem was tree roots growing into the main sewer pipe. They did the advice of the cheapest option was £1800, cash at the end of the day to unblock, cut the tree roots and reline the part that was cracked with resin. They provided a detailed report afterwards in an invoice on written paper.

Afterwards i called the insurance company - Shelias Wheels to cliam reimbursement and i included the invoice. They passed me onto Auger, who are a drainage company and who assess the claim against thier charges to feedback to the insurance. BUT Auger said they needed evidence of the work done in the form of images etc and not just the info on the invoice which detailed the work done. I didn't have it so they are unable to assess my claim.

I never thought to ask the drain company at the time to take images. I was so concerned about fixing the problem and getting it sorted for my elderly parents who need the bathroom and given that this hapened on Friday, I knew the weekend would be very difficult if i waited until Monday. 

I'm also very shy and unconfident around tradesmen as they are so confident usually and i have no idea what work needs to be done/charges so just trust them. I found this company off checkatrade and to be honest, i dont really have a problem with them. The guy did the job and fixed the problem. Its the insurance i am now dealing with that i now have an issue with.

Now im facing a fight with the insurance company to get the money back (minus excess) and i dont know what to do. 

How likely am i to be succesful if i appeal?

Please can anyone advise? 

tacpot12

You might struggle to get fully reimbursed for the work. Normally when realise that you are going to have to claim on your insurance you call them and let them know. They then tell you what you need to do. 

You didn't do this, and authorised the work on your own, so really you are responsible for paying for it. 

I wonder if you might settle with Auger for a more reasonable sum, e.g. what they would have charged.

"£1800 cash at the end of the day" should have rung alarm bells. I was offered a fix of a broken drain for £500 cash from a plumber I hired of Check-A-Trade to do a drain inspection with their camera. They were very poor throughout the inspection, and I thought £500 was very expensive. As it happens the parts have cost £50 and were easy to fit myself. You should have called the insurance company when they offered you this fix. I suspect they know that if you speak to your insurers, you will get the work done at a much lower cost or for free - so they want you to agree to the work before you have time to talk to your insurers. 

You can go to the Insurance ombudsman if Sheila's Wheels don't pay something. 

A drain camera inspection now would prove that the drains had been lined with resin. There may also be some evidence of whether this was done well or badly. If it was done badly, you have a potential claim against the contractor. Do your parents have legal expenses cover as part of their home insurance? If so, I would speak to the legal team if there is any suggestion that the repair you have paid for wasn't done to a professional standard. 
 

christophercharles

tacpot12 said:

You might struggle to get fully reimbursed for the work. Normally when realise that you are going to have to claim on your insurance you call them and let them know. They then tell you what you need to do. 

You didn't do this, and authorised the work on your own, so really you are responsible for paying for it.

I feel so stupid for not doing this. I had no idea. Ive never dealt wiht insurers before.

I wonder if you might settle with Auger for a more reasonable sum, e.g. what they would have charged

Thats what they said when they contacted me as i went ahead with someone else.They would only reimburse what they would have charged, pending full assement of of evidence. I would settle with them, just to get something and lessen the sting.

"£1800 cash at the end of the day" should have rung alarm bells. I was offered a fix of a broken drain for £500 cash from a plumber I hired of Check-A-Trade to do a drain inspection with their camera. They were very poor throughout the inspection, and I thought £500 was very expensive. As it happens the parts have cost £50 and were easy to fit myself. You should have called the insurance company when they offered you this fix. I suspect they know that if you speak to your insurers, you will get the work done at a much lower cost or for free - so they want you to agree to the work before you have time to talk to your insurers.

I trust too much. He was so confident, i felt like HE was doing ME a favour.

You can go to the Insurance ombudsman if Sheila's Wheels don't pay something.

I hope they will help. I have only a report+invoice in words.

A drain camera inspection now would prove that the drains had been lined with resin. There may also be some evidence of whether this was done well or badly. If it was done badly, you have a potential claim against the contractor. 

Should i ask Auger to do this, or the company that did the work? (They might charge for it)

Do your parents have legal expenses cover as part of their home insurance? If so, I would speak to the legal team if there is any suggestion that the repair you have paid for wasn't done to a professional standard.

Sadly, no

Thank you for the advice

MyRealNameToo

Have you checked with the trades people? They may have recorded the inspection as a matter of course and so have the images and just not automatically shared them. 

Ultimately it is your responsibility to show the losses were related to an insured peril, normally you'd do this by allowing the insurer to inspect it before attempting any repairs. When dealing with it as an emergency its always best where possible to take as many photos as possible in the hope that the insurer can assess from them if its too much of a problem to wait. 

Ultimately check with the trades, if they have them great, if they dont well at least you tried. If your insurers ultimately reject the claim then register a complaint. If you dont agree with the outcome of the complaint then you can escalate it to the Financial Ombudsman. Certainly focus on it having been an emergency and why repairs were required urgently rather than waiting for the insurer to inspect.