"No thorough inspection" = damage noticed after home insurance renewal deemed "false information"

orangeblast

Summary:

Subsidence claim denial and removal of policy has been attributed to lack of inspection at a level beyond a (in this case fairly knowledgeable) layman's ability prior to answering renewal questions, making the answers misleading - meaning that the expectation from the insurer is for there to be a professional structural assessment completed prior to every renewal. Does anyone know if this tends to be upheld as a reasonable expectation when a complaint is taken to the financial ombudsman?

Detailed version:

(I'm not the policyholder myself, and I'm posting this to have an idea of any direction I could give a family member - I am asking this in good faith and not purely out of indignation)

We had an inspection of the house due to a subsidence claim made to the insurer. This claim has been denied, and with the specific reason for denial being the inspector claiming that structural damage identified would have pre-dated [2024 renewal date], meaning that the policyholder declaring it structurally sound was misleading the insurer.

To me, this expectation that a declaration of the house being in good structural condition should always and only be made when a through specialist inspection is carried out does not appear to be a reasonable one. As context, another family member living with us does have some building skills and carries out regular 'casual' checks and maintenance - in the past we have actually had the insurer deny a claim about structural roof damage because he had repaired it himself to their satisfaction before the claim was resolved - so it would take the hiring of a specialist to conduct an inspection of the house beyond the 'level' that we are able to determine structural issues. I also don't believe expectations beyond the implied 'what you as the policyholder can determine to be true about the house' were explicitly stated and defined by the insurer, though I will have to check that.

I know that a good next step for us in any case would be asking the inspectors to detail locations of the specific area that they have determined indicate structural damage pre-dating [2024 renewal date] and hiring another inspector to see if they agree with the assessment that it is an undeniable indication of structural damage prior to that date. I will get the policyholder to ask for those specific details from the original inspection, but hiring an inspector ourselves really isn't in the cards for us when we're already facing at least paying for the subsidence repair out of pocket.

The solid route seems, then, disputing the idea that it is reasonable for the insurer to require that an inspection of the state of the house had to meet a standard beyond the ability of a non-specialist when relaying that information as part of answering renewals questions. So my question is: does anyone have any experience or even inkling of whether this is actually a dispute that the ombudsman would potentially come down on our side on? Or even suggestions for better keyword choices for searching previous cases? I do also wonder if this could be better handled by lawyering up, but it feels very unlikely that this would force a favourable resolution before getting up to the ombudsman point anyway - advice there also appreciated, if anyone has gone that route themselves.

I would be as grateful from slight feelings on this as I am for solid knowledge - when we were coming up to the inspection, I was pulling up a lot of MSE forum posts when looking into potential outcomes and all of them had informative responses that helped me feel a stronger footing going into this process, so I'm hoping there may be advice that could be offered for where we now find ourselves in this process, too. TIA!

dumpster_fire2025

As a layperson you're only expected to have the knowledge of the proverbial layperson and are not expected to get structural engineering reports every time you renew. However if there is a massive crack up the side of the side of your house, they are going to expect you to tick the box to say that there might be some problems.

I think the first thing is to find out what the inspector has actually said. Just because the subsidence was possibly present pre-2024 doesn't mean you'd notice it. But I don't know the nature of it and even then, I'm not a structural engineer so probably wouldn't know the answer even if I did know the nature of it.

Were there any signs of damage that were missed by yourself? If not you might want to start looking at getting your own report which will hopefully confirm, at least, that there is a reasonable chance the subsidence would not have been noticeable prior to renewal.

But the first step should be to see the inspectors report yourself or to at least find out how they came to the conclusion that it was pre-existing.

Grumpy_chap

orangeblast said:

We had an inspection of the house due to a subsidence claim made to the insurer. This claim has been denied, and with the specific reason for denial being the inspector claiming that structural damage identified would have pre-dated [2024 renewal date], meaning that the policyholder declaring it structurally sound was misleading the insurer.

Well, it might be possible that the policyholder (lay-person) had not noticed the potential subsidence at the time the renewal statement was made, so the statement was correct to the best of the individual's knowledge and belief.

Even if that is not plausible, the policyholder presumably had continuous insurance in place from the point at which the property was purchased and, presumably, the survey undertaken at purchase did not indicate that this subsidence was pre-existing.  In which case, the subsidence should either be covered by the 2025 policy or, if that insurer can establish that the damage was prior to that annual inception then the 2024 policy would cover the event, and so on.

sheramber

Grumpy_chap said:

orangeblast said:

We had an inspection of the house due to a subsidence claim made to the insurer. This claim has been denied, and with the specific reason for denial being the inspector claiming that structural damage identified would have pre-dated [2024 renewal date], meaning that the policyholder declaring it structurally sound was misleading the insurer.

Well, it might be possible that the policyholder (lay-person) had not noticed the potential subsidence at the time the renewal statement was made, so the statement was correct to the best of the individual's knowledge and belief.

Even if that is not plausible, the policyholder presumably had continuous insurance in place from the point at which the property was purchased and, presumably, the survey undertaken at purchase did not indicate that this subsidence was pre-existing.  In which case, the subsidence should either be covered by the 2025 policy or, if that insurer can establish that the damage was prior to that annual inception then the 2024 policy would cover the event, and so on.

It might not be the same insurer for 2024 and 2025.
 The current claim is on the 2025 policy.

If the damage was there in 2024 the cost of any repair could be more now because it has been left to get worse. 

The 2024 company may not be happy about that. 

Without details of what the damage is  we don’t know whether it was be noticeable or not. 

orangeblast

dumpster_fire2025 said:

I think the first thing is to find out what the inspector has actually said. Just because the subsidence was possibly present pre-2024 doesn't mean you'd notice it. 

Grumpy_chap said:

Well, it might be possible that the policyholder (lay-person) had not noticed the potential subsidence at the time the renewal statement was made, so the statement was correct to the best of the individual's knowledge and belief.

Ah I've made this unclear, sorry, the inspector's claim isn't that the subsidence specifically was present pre-2024, but that there is general structural damage that they have determined that the condition of the woodwork and the render indicate must pre-date 2024 - the condition of the render referring to superficial paint cracks of a 120 year old building, and the woodwork I believe only referring to some window panes, though I'll have the policyholder get in touch to clarify that.

I did have grumpy_chap's point about continuous insurance from before 2024 in mind, but I think that upon bringing this up they will point again to the premise that the '24-'25 policy was obtained with misleading information; their point will likely be along the lines of someone not currently insured by them is not able to 'back claim' for things issues that did occur during the policy period but was not claimed at the time. I will still get them to bring that up on the off chance, but the claim that the policyholder has misled them by not having a more substantial inspection is probably the main one I need to address.

I do feel reassured that both of your instincts are that it's reasonable for a policyholder to not identify and report on an issue that would have only been apparent upon a professional inspection. I'm going to contact the FCA and ABI in case either of those entities have clarified anything similar in documentation that I can refer to  - is there any chance either of you have any idea where something like that could be explicitly clarified outside of there (other than the policy document, in case that offered guidelines around this)?

TELLIT01

The basic question to be answered is whether an issue with the property would have been apparent to a layman.  As has been said in previous replies, a visible crack in brickwork, for example, should have been investigated.

sheramber

So they consider the render cracks 
have been caused by structural movement. 

Was faulty woodwork not noticed or was that considered superficial? 

Annemos

Good evening

Have you seen the replies in this Posting? I gave one case where they succeeded at FOS level. And also one where they didn't

These types of cases give you an idea of how they all think and the correct type of wording and terminology to use.  



https://forums.moneysavingexpert.com/discussion/6623370/how-to-answer-insurance-form-question-about-wall-cracks/p2


https://www.financial-ombudsman.org.uk/decision/DRN-3409566.pdf

https://www.financial-ombudsman.org.uk/decision/DRN-5317156.pdf

Here is another one I found. 

https://www.financial-ombudsman.org.uk/decision/DRN-5314608.pdf


(Just to note.... when searching for Cases like this in the FOS Website, the key words to be inputting in the search should be things like   "CIDRA SUBSIDENCE PRE-EXISTING CRACKING" 

https://www.financial-ombudsman.org.uk/decisions-case-studies/ombudsman-decisions

MyRealNameToo

Ultimately it will come down to a combination of the exact question asked and the finer details of the situation. 

If you are asked the most stringent question of if there are any cracks and there is a crack you can fit your fist in near the front door then you are going to be on ropy grounds if you declared no. If your had minor cracks that are covered by ivy on the party wall that can only be seen from your neighbours garden then you are much more likely to be able to legitimately claim you answered them truthfully and to the best of your knowledge. 

If they instead as a more general question about structurally sound then its generally easier to get away with it as saying if there are cracks or not isnt subjective whereas knowing if something is structural or cosmetic is more difficult. 

TELLIT01

Cracks in render may or may not indicate problems with the structure of the building.  Two houses of identical design and date to ours (1930s and rendered) have recently been purchased and totally refurbished.  Both had received minimal maintenance for years, and the render came away in chunks.  The new owners completely removed the render and had it redone.  The brickwork beneath the render didn't require any work.  90 year old render is unlikely to be in perfect condition.