Civil or criminal - Insurance company or police?

[Guest]

Hallo

I would be grateful for any general advice about the following.

I have had an on going subsidence claim with a major insurance company since 1999. After several years in which the company would not accept that there was subsidence at my property, remedial work was commenced in summer of 2007. I complained that the work (pilling) had not solved the problem and had left my property in a worse condition than before it had been carried out. The Financial Ombudsman Service has been less than helpful and eventually told me to "prove it". It has taken a few years to obtain an Expert Witness report which identifies that the Insurance company, their agents and the Ombudsman were all negligent.

The Report is adequate in that it identifies the negligence and goes into substantial detail about how and why the negligence occurred. What gives me cause for concern is that the report stops short of discussing what the insurance company and the builder they instructed to remedy defects did, although the Expert witness knows about this and I provided photographic evidence.

The original claim was that a garage/utility room extension was separating from the main house. The Expert Witness identified the cause as being that a drain under the garage had collapsed leaving water running to ground since 1999 or earlier, the insurance company and their agents failed to do a drains test and water continued to leak under the garage and probably house foundations. He has identified that various tests now need to be done to establish what damage has been caused and then to rectify various issues that he has identified.

What concerns me is that although he now says the garage is out-of-square and requires to be rebuilt from ground level upwards along with that section of the roof being rebuilt and mentions some fault with roof voids between the garage floor and the underlying utility room, he has failed to disclose in his report that the garage was previously rebuilt from ground level upwards, the section of the roof was not rebuilt and is consequently twisted, the insurance company and their builder intended to do a cosmetic repair by raising ground across the entire front of my house and gardens by 4 inches, raised the garage floor by 4 inches and took out the damp course that was part of the garage reconstruction and there is some visible defect in the underlying utility room that is causing the artex ceiling to peel off all along the interior wall below that part of the garage from which the damp course was removed.

I hope I have explained why I am concerned but the fact that the Expert Witness knows all this, has evidence (provided by me) and has omitted it from his report has made me suspect that as well as the negligence he identified, what the insurance company and their latest builder have done is in fact reckless and not merely negligent. The builder acted on the instruction of the person who was at the time the insurance company's Subsidence/Technical Claims manager (with appropriate qualifications) and I have only just found out the time of my original insurance claim in 1999 and up until December 2002 he was Regional Engineer Manager for the firm of Loss Adjusters appointed by the insurance company and who failed to identify the reported subsidence.

Obviously this is a total mess and I cannot begin to think how to get out of it but what I am thinking now is that the Insurance company's then Subsidence/Technical Claims manager (who was the Regional Engineer Manager for the Loss Adjusters who are identified in the Expert Witness report as being negligent for failing to do a drains test) has been criminal in instructing the builder to do what I can prove he did. The Insurance person has substantial qualifications and an extremely high profile CV. There is no way he would not have been aware of the consequences of his actions.

Anyway, to cut a long story short, should I be reporting this to the police?

Thanks for any advice or opinion you may be able to provide.

[judgemental24]

Re: Civil or criminal - Insurance company or police?

No Police as this is simply a civil claim, not Criminal to put you back into a position before the Civil Wrong (Tort) occurred.

What concerns me is that you say the reason why the extension is coming away from the house is a collapsed drain. Was this drain referenced in any planning application to the Local Authority??

The reason i ask is that my old next door neighbour built a Sun lounge and utility room on the side of his house. He concreated over a drain inspection cover during the build. A few years down the line he was unable to sell his house because of this unless he pulled down the extension..

[Guest]

Re: Civil or criminal - Insurance company or police?

Thank you for your response.

The extension was architect designed and passed by the Local Authority. That is not the problem

The problem is that a senior claims subsidence manager for the insurance company - after the point at which negligence is established and confirmed by the Expert Witness and after the point at which the garage was rebuilt - then instructed a builder to remove the damp course, raise the floor by 4", raise the outside ground level by 4" etc but would have known that his actions would have caused more problems in the future that are identified by the Expert Witness, except that the expert witness has identified multiple problems to the original garage when they in fact relate to the rebuilt garage. Isn't it a crime when someone does something knowing (by nature of his qualifications) that it is likely to cause damage but does it anyway? I'm not looking for trouble but I really cannot see a way out of this.

[judgemental24]

Re: Civil or criminal - Insurance company or police?

No not a crime, but negligence

That is why they have professional insurance policies to cover themselves (Indemnity)

That is why you seek redress in the Civil Court and let the judge decide on the evidence presented and balance of probabilities

You are subject to time constraints so unwise to let it drag out to long

[Guest]

Re: Civil or criminal - Insurance company or police?

Okay, thanks for the info. I've only had the report since mid September, am concerned that the insurance firm haven't registered my complaint about this as a complaint and apparently are going through the motions of appearing to be treating this as a new claim. I'll have to start looking for solicitors pronto and let them handle the matter.

[judgemental24]

Re: Civil or criminal - Insurance company or police?

This is way above me but you are going to have to quantify all losses up until now and what loss to put things right

As it is only a few months you are ok but you need to make an official complaint to the insurance company

Head it

Official Complaint as to your Complaints Procedure

They have to respond with a full and final to your complaint within 56 days

That gives you the option then of going to the Financial Ombudsman Service if needed and not satisfied with the original response

Send by recorded delivery as you will need a paper trail

[des8]

Re: Civil or criminal - Insurance company or police?

Could you clarify the timeline on your problems please.
I understand that in 1999 you identified a problem in that an extention to your house was becoming detached.
You made a claim under your buildings insurance in ??
Eventually the insurance company accepted the claim and remedial works were carried out in 2007.
You (and a surveyor) do not believe the works were satisfactory.
When did you first suspect the remedial works were unsatisfactory?
When did you first notify the insurers of your concerns?

I'm not quite sure where you are now:
You now believe the extention requires rebuilding, but the insurers propose raising the ground levels by 4" (or have they already raised the ground levels)??

You don't want to get involved with which builder did what, or who the claims manager worked for and when.
Your claim is with A COMPANY. It doesn't matter to you if there was collusion, or covering each others backs by employees of said company.
You might have to show THE COMPANY failed to perform its side of the contract. Don't get side tracked.

Could you tell us which insurance company is involved

[Guest]

Re: Civil or criminal - Insurance company or police?

Thanks for your response

The company is Zurich.

In 1999 I reported suspected subsidence was causing a garage/utility room extension to separate from the main house. Zurich instructed Loss Assessors who concluded there was no subsidence.

In 2003 the pending sale of the property fell through because two structural engineers acting for the proposed purchaser identified that there was subsidence.

Zurich progressed the claim slowly but their freshly appointed loss assessors in 2006 accepted that there was subsidence.

In 2007 the garage and utility room (below the garage) were piled.

In late 2007/early 2008 I complained to Zurich and the Ombudsman that I believed more damage had been caused by the remedial works than had been corrected and that I thought the property was still moving.

There followed a period of inactivity but in April 2009 the garage above ground level was rebuilt maintaining the existing roof.

In October 2009 Zurich appointed another builder to complete remedial works. I complained to Zurich and the Ombudsman about the standard of work, including the proposal to raise the ground at the sides and front of my house by 4", the garage floor by 4" and other issues. To put it bluntly, what the most recent builder did has destroyed various aspects of my property and surrounding patios and gardens. (I always believed that only cosmetic work was required to put the property back to its pre-piling high standards although I now know I was wrong about that).

A roofer replacing gutters and soffits did a roof inspection and told me that the roof area over the garage was twisted to fit the garage below it and was letting in water.

I complained again and the Ombudsman undertook a review of my complaints and in late 2010 found in Zurich's favour. I complained about the Ombudsman. Their spokesperson essentially told me to prove what I was complaining about so in November 2010 I instructed a chartered surveyor who as well turned out to be an Expert Witness whose duty is to the Courts - ie impartial.

I complained to the Independent Assessor (at that time Linda Costelloe Baker) about the Ombudsman Service and was told to obtain the report and then send it to the Ombudsman.

The Expert Witness was extremely thorough but it took a very long time to step-by-step obtain information from me including evidence. Various drains tests were also undertaken.

He did get Zurich to pay to re-route the drain, bypassing the collapsed part under the garage.

There was a lull during 2014 when he didn't respond to emails and I was too ill to pursue him (I have an incurable neurological condition which flares up occasionally).

A few months ago I made one last attempt to find out if he had given up on his instructions but suddenly this was concluded and in mid September I received his report and an Appendix, along with his instruction to send these to the Ombudsman and Zurich without delay.

The report identifies that Zurich, various loss assessors, the firm that undertook the piling and the Financial Ombudsman Service were all negligent, It sets out step-by-step the history from when the extension was built, the history of my claim to Zurich, all those appointed in respect of my claim, explains why they were all negligent and identifies a substantial part of what work is required to correct the damage to my property.

As I had been instructed by the previous Independent Assessor, I sent the report to the Ombudsman in September. The Ombudsman failed to acknowledge or respond although following response from the current Independent Assessor, at the end of last week has now made contact. I await their response.

Simultaneously I sent the report to Zurich, who have been evasive, have failed to acknowledge receipt although they have been in touch - I am concerned that this is in the hands of their claims department and they seem to be treating it as a new claim. They propose sending a claims person to my property on 23 November with their own surveyor (who I see from his website acts is someone who prepares reports in contested claims). No one at Zurich admits to having read the report.

In the last few days, studying the report again, I became concerned about a significant omission in the expert witness report - although he identifies that the garage and roof need to be rebuilt, he has omitted to say that the garage was previously rebuilt and the damage and remedial work he has identified are actually to the garage that was rebuilt in 2009 after previous piling and not the garage that existed pre-piling. Anyone reading the report would assume that the damaged garage is the garage that existed pre-piling. So now I have the added worry that, on the face of it, the expert witness may also have been negligent by the significant omission. (I have emailed him reminding him that he has evidence that the garage was rebuilt and asking if he wants to take the opportunity to correct the omission from his report).

I also seem to have identified the subject matter of a new complaint to Zurich - something that is not covered in the expert witness report.

What distresses me is that this has been on-going now for 16 years with no end in sight, that my husband died in 2008 not knowing about this situation, and that at 73 years myself I'm not indestructible (even though I like to think I am) and I really need to get this sorted out so that my problem does not because my daughter's problem.

So again, thanks for your response, and as you can all see, any assistance will be gratefully received.

[des8]

Re: Civil or criminal - Insurance company or police?

You've certainly not had good service.

IMO you should wait until the next inspection later this month.
Give to the Zurich employee a letter explaining you are no longer prepared to countenance their bad service, and give them say, 14 days in which to come up with their proposals.
If they fail, or do not make suitable proposals, you will take matters further.

Then if the proposals aren't acceptable, or not made complain to the CEO.

You explain to him it is not acceptable and if things are not put right you will proceed to court.

Your claim would be on two fronts
1. Breach of contract. Your policy requires that in the event of a insured loss the insurers will put you back in the position you were before the loss.
This they have failed to do (raising the ground level to cover their errors!!!!!!!!!!)
2. Under the Supply of Goods and Services Act 1982 work has to be carried out with reasonable care and skill. This appears to have been lacking!

[Guest]

Re: Civil or criminal - Insurance company or police?

Thank you for this advice.

I have thus far refused to countenance a claims assessor, insisting that as the last Zurich employee to deal with this matter was at the time Subsidence/Technical Claims Manager (now Global Head of Catastrophe Claims), I will only deal with someone of similar standing. They seem to be taking notice as, from a claims technician as they originally intended, Zurich have now upped the ante to John Huxham, BSC, MRICS, FCICA, Senior Claims Manager.

I have also contacted the Chief Executive Officer, who has not responded although he has acknowledged receipt of my communication including the attached reports. Of note is that the report files were deleted by some identifiable Zurich employee so there is no evidence that the CEO has actually seen or read the report.

I note your advice re a letter, and also the basis of any claim. I appreciate your response. Thanks for taking the time.

[Guest]

Re: Civil or criminal - Insurance company or police?

Further to my request for help, I would be grateful for more advice please.

Given that this matter stems from my 1999 subsidence insurance claim and that, in good faith and in accordance with the Financial Ombudsman telling me to "prove it", I sent the recently-produced expert witness report to both Zurich and the Ombudsman in late September, Zurich are being evasive, in particular with regard to my question "are you treating this as a new claim"?

This is NOT a new claim but an on-going complaint about an existing claim. Is it important that Zurich recognise this before I allow them onto my property? And am I right to insist that they clarify their apparent intention to treat this as a new claim?

Thank you for any further advice

[des8]

Re: Civil or criminal - Insurance company or police?

I doubt if the insurers have decided how they are going to deal with this matter.
You made a claim, which they considered settled.
You have now raised concerns which you claim to be due to their poor workmanship.
They will want to assess the problem before deciding if it is a new claim, or a problem arising from the original claim.
At the moment I suspect they have neither confirmed nor denied that they even accept liability for the problem, either as a new claim, or an ongoing claim.
I see no reason for not letting them carry out an inspection.
In fact to hinder them could be seen as obstructive, and will not do your case any good at all.

Presumably your concern is that if treated as a new claim you will be liable for the excess?

[Guest]

Re: Civil or criminal - Insurance company or police?

I made a claim which was never settled - the Financial Ombudsman Service having told me to "prove" my allegations and when I had received the independent report I commissioned, to send this to the Ombudsman and to Zurich.

Zurich have always known that the claim wasn't settled, in fact whilst the report was being prepared, they paid for an essential repair that the expert witness identified as being urgent.

Zurich wrote to the expert witness saying that the claim was not closed and they would not do any more work until they were instructed by the Ombudsman.

No my concern is not particularly that I will be liable for the excess - rather, my concern is (a) getting my house and gardens put back in the condition they were in when the claim was first made and (2) how to get substantial compensation because Zurich's failures prevented the sale of the property in 2003, rendered my house unsellable and put me in a position where I have been dependent on savings to pay the bills incurred by living in a property that would have been sold twelve years ago but for Zurich's failures.

Thank you

[des8]

Re: Civil or criminal - Insurance company or police?

Well at the end of the day you will have to allow them access to assess the problem.
They will not progress the matter without seeing it.

If things don't proceed the way you want, finally there are the courts.(post 9)

[stevemLS]

Re: Civil or criminal - Insurance company or police?

Your Expert Witness is not acting as such and owes no duty to the court in the way that you describe.

He only does that when instructed in the context of proceedings which is when the obligations in part 35 kick in.

He is neither "Expert" nor "Indepenent" as he is instructed by you.

He may well act as an Expert Witness in other matters, but not this one.

It is an important distinction and not splitting hairs.

That is not to say his report is without weight.