How to escalate to Financial Ombudsman (Subsidence Insurance Claim) (

MaidaVale3499

Can anyone offer me some guidance re taking a case to the Financial Ombudsmam?

On behalf of my late 88 year old father, the Insured, I instigated a subsidence claim on his home insurance policy with XYZ in Nov 2020.

After multiple attempts by XYZ and their loss adjusters (360 GlobalNet) to deny subsidence (including wanting to send in a painter & decorator to literally paper over the cracks and on a different occasion wanting to commence power grouting under a party wall without a party wall agreement).  I hired our own Structural Engineer to inspect and produce report.  His report concluded the semi detached bungalow has major and progressive subsidence.  In his opinion a full demolition and rebuild as detached would be the only solution that placed my father in a pre loss pre damage position and did not risk damaging attached property.

Aug 2023
360GN on behalf of their client XYZ after further multiple inspections, surveys, ground surveys confirmed to my father that they concluded the same as our SE.  360/XYZ offered to buy my father out of the claim.  This was rejected as my father felt that he would struggle to purchase a like/like bungalow and requested that XYX be responsible for the project.  360/XYZ accepted this and commissioned our SE for the project.  An architect was also commissioned by 360/XYZ.  All instructions have been issued by 360/XYZ to both SE & architect, they also invoiced 360/XYZ and were also paid directly by 360/XYZ.

Oct 2023
My beloved father died suddenly and I wholly inherited the bungalow and the claim.

Dec 2024
Full Planning Approval received.  36O/XYZ instruct Architect to complete Building Regs Spec & Drawing and Builders Tender Document BUT not to the overall Project Manager.  No PM was appointed.
360/XYZ instructed  SE to draw up structural plans and obtain piling drawing and quote.

Jan 2025 to Dec 2025
Minimal if any progress made as 36O/XYZ failed to manage rebuild project but also failed to pay architect to such an extent that he withdrew his services until payment was made.  Architect has not completed any of the above and has not been managed by 360/XYZ in any way.  Piling plans were submitted to 360 for review in July 2025 and in Jan 2026 360 finally said they had reviewed but wanted another company to quote.  Visit booked Feb 2026 for Bearings Structural Solutions to view bungalow.

Throughout 2025 I emailed both 360/XYZ requesting updates on the rebuild project, asking for copies of project plan, project milestones, Escalated to a formal complaint in Sept 2025 to XYZ

Oct 2025 (4 weeks later)
Complaints Dept for Complex Claims email to advise that they are still reviewing my complaint.

Nov 2025
Ditto

Dec 2025
I chase for a response to my complaint (& also still no progress from Architect).
A team member of XYZ's Complaints Dept for Complex Claims emails to advise that she won't be able to respond to my complaint or give me a date when she can respond because "this is dependent upon the claim progressing to a point where the next steps have been proposed".  She advised that she would ask my Claims Manager to update me.

12th Jan 2026
Having received no update I send a letter by Signed for Delivery to the offices of the CEO Designate and the Director of Customer Relations of XYZ

16 Jan 2026, 1530hrs
I receive a phone call from my Claims Manager (John).  He referred to being aware that I had written to the CEO.  He started by saying that I wasn't going to like what he had to say.......he then told me that neither 360 or XYD were managing the rebuild project but I was!!!!!  I challenged this immediately and requested that he provide me with copies of all communications to me from 360/XYZ in which I was advised of this AND that I had accepted this.
John stated that XYZ would pay for an Architectural Project Manager and quoted a sliding scale of 8 to 14%).
John advised that XYZ would still be funding all groundwork required for rebuild of bungalow plus the neighbour’s property receiving a new external gable end and being made a fully detached property.
John also confirmed that the cost of the rebuild would still be funded, subject to approval by 360/XYZ of tenders.
John also added than any betterment to the Rebuild (excluding any improvements required by Planning and Building Regs) would need to be funded by me.  I have nil objection to this and I confirmed I understand the principle of "no customer should profit from a loss".  I belive its called the Indembity principle.
John also confirmed that I was entitled to alternative accommodation for the period of the works which would be funded by XYZ but that I was responsible for sourcing my own accommodation.  Can that be right?  (Fortunately I have a property of my own which I will move back into for the period of duration).  John confirmed that XYZ will make payments to me for the equivalent rental cost of leasing a property similar to bungalow.
John confirmed that mail redirection services would be paid for by XYZ during the relocation period.
So yes alotbof positives HOWEVER this does not negate that a full year has been wasted by XYZ failing to project manage the rebuild or to advise me that I was responsible but that I could hire a Project Manager which XYZ would fund.

20th January 2026
I am advised by XYZ that a new Complaints Team member is looking into my complaint at the behest of the Director of Customer Relations.
I acknowledge her email and email an updated complaint which includes the issue if my having been informed fir the first time on 16th Jan 2026 by XYZ Claims Manager that I'm managing the rebuild.  I also include, to be positive, what I regard as the way forward eg what success looks like which was basically:
- XYZ Claims Manager to respond quicker and in a reasonable timeframe
- XYZ Claims/360 to review and approve quotations for Project Manager and All other required services eg Asbestos/Demolition survey within a reasonable timeframe.
I also requested confirmation from XYZ re what response times I could expect from XYZ Claims Team going forward (as previously months and months pass without any progress or communication to me)

21st January 2026
New Claims handler confirms that her role is limited to investigating my complaint and she has referred me back to John in Claims as "he is in the strongest position to give you the information you need".

Throughout all of this I'm residing in a bungalow with evermore cracks appearing and widening by the day, tiles are being pushed off bathroom walls, doors no longer fit in doorways, the lounge floor drops 8 inches across its length.  Coving is splitting.  I need to replace lounge furniture but the new bungalow has had to have diff shaped lounge and so different size sofas are needed for new.  
XYZ will also provide no methodology to me regarding how we will calculate betterment or "detriment" (no chimney breast, fireplace, gas fire, etc)

I'm at my wits' end and seriously stressed and I'm finally realising that XYZ will not improve their service to me of their own volition.

 So......any advice re when I should escalate to the Financial Ombudsman and guidance on how to submit an effective time complaint/escalation?

Thank you

XRS200

Sorry, I haven't read every word.  But there will be a complaints procedure in the policy.  Insurer has 8 weeks to respond and should provide info on ombudsman process.  If they don't respond in 8 weeks, go to the Ombudsman website and it explains what you have to do.

Annemos

Gosh this is awful for you. I will try my best. But I am also just a homeowner, too, who had a Subsidence Claim and had to go the FOS. 


If we send in a Complaint to an Insurance Company, they have 8 weeks to respond. If they do not send us a Final Response within that Time Period, then we can go to the FOS. Otherwise, we can go to the FOS, as soon as we have received that Final Response. But we also need to watch out for the 6-month time restriction below. 

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Your own Case:    



1       You said this.........  "Escalated to a formal complaint in Sept 2025 to XYZ"

Some things to note.   Have they actually sent you a Final Response to that Complaint?  (Make sure that you are absolutely sure whether or not they did send you a Final Response.)

If they HAVE sent you a Final Response, then you must go to the Ombudsman within 6 months of the date of that Final Response, or the FOS will possibly say they cannot look at the Complaint.  

Given that time restriction, I would be keeping an eye on that deadline, so you do not miss it. Get a Complaint in before the 6 months lapses. 

Here is what the FOS says on their website .......

https://www.financial-ombudsman.org.uk/consumers/expect/time-limits

How long you have to complain to us after receiving the final response

After you’ve complained to the business and you’ve received the business’s final response, you have six months from the date on the final response to refer your complaint to us.

For certain complaints relating to car finance, you may have up to 15 months from the date of the final response to bring your complaint to us.  

If you complain later than this, we usually won’t be able to help unless:

• the delay is due to exceptional circumstances – for example, you were seriously ill during the time when you should have referred your complaint
• the business didn’t send a valid final response, or
• the business agrees to us being involved after the 6 months time limit has passed

If a business doesn’t consent to us investigating a late complaint, we’ll look into what’s happened and decide if we agree the complaint is out of time. If you have exceptional circumstances for the delay, we may still investigate the case, even if the business hasn't given their consent.

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2   Another thing to note, is that when reviewing a Case, the FOS will only consider all the Facts that have taken place up to the Date of the Final Response. So, nothing that took place afterwards. 

This means, that in effect, another Complaint has to be submitted to the Insurance Company (and the "8- week process" gone through all over again), for the new things that have happened since that previous Final Response for the previous Complaint!

In my case the FOS Case Handler did get consent from the Insurance Company to consider things that had happened after the date of the First Final Response. But I don't know if that would typically happen. 

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3   When doing the FOS Complaint, try very hard to pull out the main facts of the main Complaints as concisely as possible. (The FOS does not need to have a blow-by-blow account of everything that has gone on for the whole Subsidence Claim.)

In your Summary above, I wonder if you could pull out the actual Subject Areas for your Complaint into headings, so they stand out. Take out any padding, if you see what I mean. And make it clear what it is that you want, so that stands out too. 

Good luck with this. (I spent ages on mine... had to sleep on it!) 

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4   I am going to attach some random FOS Cases here, so you can see how Complaints are handled at the FOS. The FOS is not a punitive body and amounts paid for "Inconvenience and Distress" are not as high as one would perhaps expect. This first one was one of the higher ones at 5000 pounds.

But what is good, is that it can help put an end to stalemates. The FOS can give instructions that the Insurance Company must carry out, as you can see in the second Case.......    "Insurance Company must carry out a comprehensive review of the claim and communicate their findings - and the proposed way forward - to Mrs D and Mr D, as described above. This must be completed within two months of Mrs D and Mr D’s acceptance of this final decision."

And the third Case also gave detailed instructions of what they had to do. 


https://www.financial-ombudsman.org.uk/decision/DRN-2812072.pdf

https://www.financial-ombudsman.org.uk/decision/DRN-5180076.pdf

https://www.financial-ombudsman.org.uk/decision/DRN-5484052.pdf

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5   Please note this Limit of 445,000 pounds that the FOS also has:  

The limits that apply

There is a limit to how much we can tell a business to pay when we uphold complaints. But we can recommend they pay you more if we think it’s fair.  

If we think your compensation is over this limit, we’ll contact you about what that means. 

For cases referred to us on or after 1 April 2025, about acts or omissions – that is, the cause of the complaint – that occurred on or after 1 April 2019, our award limit is £445,000. 

Different limits apply depending on when the case was brought to us. 

https://www.financial-ombudsman.org.uk/consumers/expect/compensation