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  • FIRST POST
    • MSE Archna
    • By MSE Archna 21st Jul 09, 12:18 AM
    • 1,874Posts
    • 6,140Thanks
    MSE Archna
    Great 'How to ensure your insurer pays claims' Hunt: How to assure a payout
    • #1
    • 21st Jul 09, 12:18 AM
    Great 'How to ensure your insurer pays claims' Hunt: How to assure a payout 21st Jul 09 at 12:18 AM
    It's all very well having insurance, yet if when you come to claim, the company rejects it, the whole thing's pointless. So we thought we'd tap MoneySavers' knowledge to find your top tips on making legit insurance claims. What were you claiming for, what details did you include, how did you speed it up, what tips do you have for others?

    If your claim's rejected remember you have a right to take it the Financial Ombudsman Service. See the Fight Bank Mistreatment

    This Forum Tip was included in MoneySavingExpert's weekly email

    Don't miss out on new deals, loopholes, and vouchers

    Last edited by Former MSE Wendy; 21-07-2009 at 7:45 PM.
    Report inappropriate posts: forumteam@moneysavingexpert.com




Page 1
  • Gaye_Hood_Henry
    • #2
    • 22nd Jul 09, 9:17 AM
    • #2
    • 22nd Jul 09, 9:17 AM
    I had a car accident which very clearly wasn't my fault (other car on wrong side of road). I was due to take my car to continent for holiday - evidenced to insurance company by ferry tickets - and was very careful to ensure everyone agreed before I hired a replacement car to take instead.
    However when claim finally 'settled' £2,500 was unpaid for the replacement car hire.
    No movement whatsoever with the usual requests, common sense discussions (and begging!) so how did I resolve it?
    I informed them I was coming down to their London head office and would stay in their reception until I received a cheque for the full £2,500. Furthermore if the cheque was not in my hands within 1 hour of my arrival I would use my mobile phone to ring all my many contacts within the newspaper and television industry to allow them to send reporters and crews to interview me and see the supporting documentation that I would have with me agreeing the replacement car hire. I told them this sort of complete travesty is just what the papers love to print!
    I arrived and was given the cheque within 20 minutes of my arrival.
    Incidentally I don't have any contacts in the world of media but it might be useful to make some if, in some future instance, bluff and bull DOESN'T baffle blatant bilkers!
    Gaye xx
    Save on washing-up too.... eat from the tin!
    • Starquest
    • By Starquest 22nd Jul 09, 9:41 AM
    • 2 Posts
    • 4 Thanks
    Starquest
    • #3
    • 22nd Jul 09, 9:41 AM
    Re Insurance Claims
    • #3
    • 22nd Jul 09, 9:41 AM
    We recently had a claim for a house fire caused by an electrical fault on the TV. Best advice we received was to use an independent Assesor working for us, we found one in Yellow Pages. He dealt totally with the insurance company and their assesors securing an excellent service - we had no need for any discussions with the insurance company - the assesor handled it all, even the paperwork. The assesor had worked for insurance assesors so knew what would be allowed so no need for any dispute and we gained where we would have had a problem. He then commissioned the builders who completed the work to our satisfaction and arranged payment to them. He cost us nothing as the builder paid a commission - nothing to do with us. Even had we paid, the service would have been worth it.
    • Katie-Kat-Kins
    • By Katie-Kat-Kins 22nd Jul 09, 10:12 AM
    • 1,681 Posts
    • 1,780 Thanks
    Katie-Kat-Kins
    • #4
    • 22nd Jul 09, 10:12 AM
    • #4
    • 22nd Jul 09, 10:12 AM
    The first things to ensure are:
    1. That you claim is honest and genuine, insurers are really tightening up on dishonest or exaggerated claims. Many people think that insurance companies are "fair game" and that a bit of artistic licence when submitting the claim is in someway justified. It isn't and if insurers get wind that you have been less than honest in any part of your dealings with them then they can make your claim very difficult. They could even bring a criminal prosecution.
    2. Make sure that you have cover for the right things and at the right level, many problems arise because people haven't read and understood the policy at the outset. Check whether you are covered for loss or just theft for example.
    3. Before you claim make sure your claim is covered, there is no point putting in a claim for something you are not insured against.
    4. Be aware of all the conditions with your policy, if you do not follow them all your cliam may be rejected, for example for failure to notify your insurers promptly.
    5. Be honest when you take out your policy, what could be seen as a little white lie to get a cheaper policy could invalidate your cover down the line.
    6. Submit your claim promptly, honestly and include as much evidence as possible. Keep copies of everything you send just in case there is a problem in future. Include, photographs, receipts and a full and clear account in legible handwriting.

    Hope that helps a few people!
    Last edited by MSE Jenny; 24-07-2009 at 5:47 PM.
  • dinesh17
    • #5
    • 22nd Jul 09, 10:16 AM
    Insurers will try every trick in the book
    • #5
    • 22nd Jul 09, 10:16 AM
    I disagree with Dan Thomas, I had a legitimate claim "repudiated" by the insurer's loss adjuster for the simple reason that the policy did not cover my type of claim (water damage from a kitchen leak).
    I then looked in the policy document where it quite clearly stated that the policy DOES cover such claims.
    I had terrible hassle with the loss adjustors who took ages to do anything and would keep trying to settle my claim as cheaply as possible. I went from being offered zero, to £1k, to £2k and finally £5.5k. You have to persevere, provide your own quotes (as the insurers will claim that things such as your carpet are worth far less than they really are) and ask for a breakdown of the settlement by component part - I did this and found out they werent paying for a lot of things.
    I think Starquest's tip of hiring someone to do the claim for you is probably the best advice - what I will do next time if I have to claim.
    • geri1965
    • By geri1965 22nd Jul 09, 10:16 AM
    • 8,366 Posts
    • 14,004 Thanks
    geri1965
    • #6
    • 22nd Jul 09, 10:16 AM
    • #6
    • 22nd Jul 09, 10:16 AM
    Insurers don't just reject claims because they feel like it - they do it because whatever you're claiming for isn't covered. If everyone actually read and understood what they're getting into, 90% of the complaints in this forum wouldn't exist.
    Originally posted by Dan Thomas
    This is a good tip, and it also helps because a lot of the people you deal with in insurance companies don't know what their own policies cover.

    I've been told twice by insurers that claims aren't covered - on close reading of the policy wording they are, and when I call back and query it, they usually refer it to a supervisor who tells them yes, it is in fact covered. :rolleyes:
  • dinesh17
    • #7
    • 22nd Jul 09, 10:31 AM
    • #7
    • 22nd Jul 09, 10:31 AM
    Dan, I was disagreeing with your quote "Insurers don't just reject claims because they feel like it - they do it because whatever you're claiming for isn't covered."
    In my case I proved that they were incorrectly rejecting my claim for no plausible reason and anyone I am sure their loss adjusters are incentivised to limit the level of claims for valid reasons or otherwise!
  • LadyIndecisive
    • #8
    • 22nd Jul 09, 10:35 AM
    • #8
    • 22nd Jul 09, 10:35 AM
    'Top tips on making legit insurance claims'?

    What, as opposed to non-legit insurance claims!?

    AS Dan T says, if your claim is covered (and not fraudulent) it will be paid. If it's not, then it won't. If there's some kind of ambiguity the FOS make an independent final decision.

    Threats of 'going to the papers' or Watchdog are not new and will have been heard before.

    If you think you have a valid claim, fully document it and evidence it, take the names of everyone you speak to, put everything in writing wherever possible, plus keep calm and don't swear at the claims person or be rude or threatening as this will be noted on your file, which may end up with the FOS.
    • pedro123456
    • By pedro123456 22nd Jul 09, 10:40 AM
    • 710 Posts
    • 222 Thanks
    pedro123456
    • #9
    • 22nd Jul 09, 10:40 AM
    • #9
    • 22nd Jul 09, 10:40 AM
    More words of wisdom :rolleyes:

    Here's an incredible tip:

    Read the policy wording (all of it) before taking out the policy. Make sure you understand it before purchasing the product.

    Insurers don't just reject claims because they feel like it - they do it because whatever you're claiming for isn't covered. If everyone actually read and understood what they're getting into, 90% of the complaints in this forum wouldn't exist.

    -Policy wording as T&C are there to protect the IC, not add clarity for the customer.
    -IC's reject claims because they dont like paying up, they like monthly payment though :rolleyes:


    My tip is for the IC's to be brought in line like the banks, and have their power challenged.

    http://www.ft.com/cms/s/0/f2705618-7628-11de-9e59-00144feabdc0.html
    Last edited by pedro123456; 22-07-2009 at 10:45 AM.
    Campaigning to recycle Insurance Policies into Toilet Paper

    Z
    • Katie-Kat-Kins
    • By Katie-Kat-Kins 22nd Jul 09, 10:41 AM
    • 1,681 Posts
    • 1,780 Thanks
    Katie-Kat-Kins
    'Top tips on making legit insurance claims'?

    What, as opposed to non-legit insurance claims!?

    AS Dan T says, if your claim is covered (and not fraudulent) it will be paid. If it's not, then it won't. If there's some kind of ambiguity the FOS make an independent final decision.

    Threats of 'going to the papers' or Watchdog are not new and will have been heard before.

    If you think you have a valid claim, fully document it and evidence it, take the names of everyone you speak to, put everything in writing wherever possible, plus keep calm and don't swear at the claims person or be rude or threatening as this will be noted on your file, which may end up with the FOS.
    Originally posted by LadyIndecisive
    You'd be amazed at how many non-legit claims there are out there!!!! From the classic spilt paint on the carpet and oooh whoops it got the sofa too, or got burgled and your cd collection doubled in size for the claim type issues to full on completely faked road accidents.

    Insurers are wise to this and if they detect the slightest whiff of anything dodgy will make things very difficult.

    Lying to your insurance company is fraud and is treated as such by the courts.
  • LadyIndecisive
    Yes, I know this, I investigate fraudulent claims, that's why I thought it was funny!
    • Katie-Kat-Kins
    • By Katie-Kat-Kins 22nd Jul 09, 10:49 AM
    • 1,681 Posts
    • 1,780 Thanks
    Katie-Kat-Kins
    More words of wisdom :rolleyes:

    Here's an incredible tip:

    Read the policy wording (all of it) before taking out the policy. Make sure you understand it before purchasing the product.

    Insurers don't just reject claims because they feel like it - they do it because whatever you're claiming for isn't covered. If everyone actually read and understood what they're getting into, 90% of the complaints in this forum wouldn't exist.

    -Policy wording as T&C are there to protect the IC, not add clarity for the customer.
    -IC's reject claims because they dont like paying up, they like monthly payment though :rolleyes:


    My tip is for the IC's to be brought in line like the banks, and have their power challenged.
    Originally posted by pedro123456
    Helpful! :confused:

    Policy wording is the form of your contract with the insurer, it covers exactly whatyou are paying for and what EACH parties rights are. As the accounts above prove reading it and understanding it is for your own benefit so that you can ensure you recover what you are entitled to and are protected against the risks you want to be protected against. Anyone who doesn't read the T&Cs wants their head looking at.

    Insurance companies are businesses, if they paid thousands and millions out on claims they could avoid they would go bankrupt in no time. I do a lot of work with insurance companies and know that often they do pay claims that they could technically avoid, they aren't monsters, but they aren't charities either. Make sure that you are paying for a product that meets your needs - read the policy!!!
    • Katie-Kat-Kins
    • By Katie-Kat-Kins 22nd Jul 09, 10:51 AM
    • 1,681 Posts
    • 1,780 Thanks
    Katie-Kat-Kins
    Yes, I know this, I investigate fraudulent claims, that's why I thought it was funny!
    Originally posted by LadyIndecisive
    Oops sorry! Didn't read like that!

    Still I guess we don't want too many people to stop making dodgy claims or we might end up out of a job!!
  • LadyIndecisive
    I think we will continue to be busy, don't worry
    • Katie-Kat-Kins
    • By Katie-Kat-Kins 22nd Jul 09, 11:04 AM
    • 1,681 Posts
    • 1,780 Thanks
    Katie-Kat-Kins
    Sooo a good illustration of what we are advising then!

    *warning ladies and gentlemen if you don't read the terms and conditions you could end up like pedro*

    It really is the most common complaint about insurers, I've seen it on other sites too, people think policies are one size fits all, or will do everything they can for the cheapest possible policy ignoring the fact that saving £10 on the policy may cost them £1000s if it doesn't meet their needs.
    • pedro123456
    • By pedro123456 22nd Jul 09, 11:07 AM
    • 710 Posts
    • 222 Thanks
    pedro123456
    Policy wording is the form of your contract with the insurer, it covers exactly whatyou are paying for and what EACH parties rights are.
    Yes you are right, its policy wording by the IC for the IC, and it needs challenging, to promote fairness and equality for both parties.

    Anyone who doesn't read the T&Cs wants their head looking at. That'll be most people then, as they are writen in such a way as to confuse, being subjective doesnt help matters.

    Insurance companies are businesses, if they paid thousands and millions out on claims they could avoid they would go bankrupt in no time Profits are one thing, greed is another.

    I do a lot of work with insurance companies and know that often they do pay claims that they could technically avoid My guess is that they pay these claims if it is finacially cheaper, not through the goodness of their hearts.

    The insurance industry needs more transparency and the playing field needs leveling up somewhat, so far it unbalanced in favour of the IC's, thats why the Industry makes millions and thats why there is no public confidence in the Insurance Industry.

    I do however agree there are fraudulant claims, just like we the public have to endure a criminal ellement the IC's do too, the costs of these fraudulant claims are build into the policy premiums in any case aint they?
    Campaigning to recycle Insurance Policies into Toilet Paper

    Z
  • dinesh17
    Can I just add that some policies use such vague wording that the insurer can interpret it to suit any situation so as to not pay out - I know for a fact that one of the large banking groups of this country (clue is in the name) had a home emergency cover for which they would use their loosely worded terms to say that any situation is not covered under the policy.
    I agree that people should read the T&Cs but not everyone has the ability nor the foresight to know how the wording will come back to bite them in a particular situation.
  • poet123
    I came a cropper when I assumed that travel insurance would cover me for goods stolen.....whilst travelling.:confused:

    Last year we were en route to the airport in Barcelona with a car full of the luggage a family of 5 needs for a 3 week holiday. We had driven up from France, stopped to stretch our legs and eat, were away from the car no more than 45 mins, and it had been robbed, brick through window.

    Were we covered ? no, because apparently personal posessions are covered only if in a locked hotel room. Granted, it was there in the small print, but it seemed unfair that a travel policy should have such an exclusion. We eventually claimed on our contents insurance but because of a limit, lost out to the tune of approx £800.

    Lesson learned.
    • Katie-Kat-Kins
    • By Katie-Kat-Kins 22nd Jul 09, 11:33 AM
    • 1,681 Posts
    • 1,780 Thanks
    Katie-Kat-Kins
    No but most people are literate enough to understand a policy booklet that says that items are covered for theft outside the home but not loss or that pre-existing medical conditions are excluded. You may not understand the minutiae of the actual policy but the chances are that these are not the things that will cause problems and if they are an insurer will be lenient if it is down to a genuine mistake.

    If you find the actual policy complex the accompanying booklet is normally written in "plain english", or you can always contact the insurance company or your broker for clarification.

    However once you accept the policy you accept all the terms, unless you have agreed a variation in writing with the insurance company.

    In my experience it is often the most basic things and not the technically complex that cause problems. I regularly come accross claims that could be avoided by insurers because they have not been notified promptly (often years having passed). It is very straight forward to understand that any circumstances which could give rise to a claim should be reported to insurers without delay. So why do I constantly see people who are often intelligent responsible individuals saying, oh I didn't report the accident because I didn't think he'd make a claim, or because it wasn't my fault???? And this goes to the highest level, managing directors, head teachers, etc

    Potentially you put yourself (and your company) at risk of having to personally meet a claim which could run to £1,000,000, for the sake of spending 10 minutes with the policy booklet.
    • pedro123456
    • By pedro123456 22nd Jul 09, 11:42 AM
    • 710 Posts
    • 222 Thanks
    pedro123456
    Dinesh you are not alone in your interpretation, ICís word their T&C and Policy wording in such a way that they are flagrantly in their favour, often being subjective and open to opinion, sadly this gives them the power to be the Judge & Jury of any claim made. :confused:
    Of course ďeventuallyĒ if you havenít been beat down with their power you can ask for the FOS for a ruling, but this is many months down the road.

    Itís ironic IMO, that the ABI (Who represent the collective interest of the ICís), are endeavouring to ďpromote public confidenceĒ in the Insurance Industry. While at the same time highlighting the apparent fraudulent claims!!!!!!

    So it appears we donít trust them and they donít trust us???????


    Anyway this is my last input on this particular thread, Iíll watch from the sidelines
    Campaigning to recycle Insurance Policies into Toilet Paper

    Z
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