Insurance company refusing payout after burglary

[Amethyst]

Re: Insurance company refusing payout after burglary

Okay this is the clause they're relying on now

[Amethyst]

Re: Insurance company refusing payout after burglary

http://www.mondaq.com/x/40310/Reinsu...+Forrest+v+CGU
Forrest & Sons Ltd v CGU Insurance Plc


Am going to find out if we have written acceptance than the non occupation clause didn't apply and this is the only bit they are relying upon.

[enaid]

Re: Insurance company refusing payout after burglary

So the change they mean is it became 'unoccupied'? so the 'risk' was increased

Well you have to ask just how they EXACTLY determine 'unoccupied' as it is not clear in their T&Cs as the property although not slept in was never not visited for more than a period of 3 days let alone 30

You have em by the short 'n'curlies imo

[Amethyst]

Re: Insurance company refusing payout after burglary

mmmm I think so, just waiting on their final response so we can go to Greenwood then FOS so will look at it more once we have it in writing. Everything so far has just been by tellingbone.

[enaid]

Re: Insurance company refusing payout after burglary

mmmm I think so, just waiting on their final response so we can go to Greenwood then FOS so will look at it more once we have it in writing. Everything so far has just been by tellingbone.

and I thought you knew the rules xx lol

[Amethyst]

Re: Insurance company refusing payout after burglary

shhhhhh


for ref from the FOS page

In a number of cases, that may result in our deciding that, so long as the insured property was visited on a reasonably frequent basis, then it was "occupied", even though the policyholder was not sleeping there every night. It is important to stress, however, that we look at the facts of each case on their own merits, rather than applying a strict rule.

We do not consider it good practice for insurers to decline to pay out where the policyholder's breach of a policy condition has been only a technical breach that has not prejudiced the firm's position in any way. So, for example, if it can be established that the event that gave rise to the damage occurred within the first 30 days of the property having been left "unoccupied", then the firm should normally meet the claim, even if the property was not actually visited for a longer period. In such cases, the fact that no one lived in, or visited, the property was probably not material to the circumstances of the loss or damage.

Having said that, we are unlikely to support a policyholder who misrepresents the true situation when taking out or renewing their insurance. Nor are we likely to support a policyholder whose property has simply been abandoned, or has been so neglected that it practically invites unwelcome attention.

[des8]

Re: Insurance company refusing payout after burglary

You might also find the following useful;
The doctrine of Utmost good Faith means that non disclosure of a material fact, or non disclosure of a change in a material fact makes a policy voidable.
However this strict legal position in the UK is amended by the ABI Statement of General Insurance Practice, in relation to persons insuring in their private capacity.Under this agreement, members of the ABI will not repudiate liability to indemnify a
Policyholder on grounds of non-disclosure of a material fact which a policyholder could not
reasonably be expected to have disclosed, or on grounds of misrepresentation unless it is a
deliberate or negligent misrepresentation of a material fact.

I'm looking to find the exact wording and ref. numbers etc, but thought this was something to be considering.

[des8]

Re: Insurance company refusing payout after burglary

Further thoughts:
NIG policies are only available through brokers : were you properly advised by your broker?

NIG policies are underwritten by UK Insurance limited. You might find complaining to them useful.
UK ins. are members of ABI, but NIG aren't as they aren't really insurers.

[Amethyst]

Re: Insurance company refusing payout after burglary

I think it was a local broker firm that has been used by the family for the last million years (over familiarity maybe) I'll have a word on that front.

It was only 'empty' 3 months and during that time my parents stayed there for two weeks while working on it, and I was there for days on end, not nights though, painting and cleaning and stuff, cutting grass, showing estate agents round etc etc - I'd been in to change over water in dehumidifiers a couple days before Christmas Eve and everything was locked up and fine, then the police called.

I think we should have a half decent shot through the ombudsman. It is only buildings insurance, not contents, hence why its such a pain, if they'd just nicked a telly (which they did as well) then okay thems the breaks, but they have rendered the house uninhabitable by half hour of yanking pipes out from the floor.

The week after our house was burgled next doors was raided for drugs and is now a boarded up shell, so it's not going to fetch the greatest price on the open market anyway, but be nice not to lose the extra money through the damage the scroats have done too. (I don't think next door' owner is being paid out on his insurance either, and they used our fence to light fires in his living room!)

(sorry just rambling on there)

[des8]

Re: Insurance company refusing payout after burglary

Just to cheer you up..... have you seen how long FOS are taking to produce initial decision.
This tends to support insurers , so then you have to wait to have complaint heard by ombudsman.
If NIG have given you their final decision I would certainly try the insurers first. Why deal with the monkey when there's an organ grinder.
NIG are only agents.

[Amethyst]

Re: Insurance company refusing payout after burglary

yeah thanks for that des

Had letter from the insurance 'intermediateries' all seems a bit complicated - they seem to act on behalf of NIG.

We go to a broker to get our insurance - they arrange everything and we get the policy docs from NIG. When the house was burgled the brokers sent an agent to sort out initial problems (he put some water condensing units and fans in to try dry it out and got people in to make the electrics safe etc) While that was going on we were broken into again and the insurance brokers agents equipment that was is the house was stolen - we're finding out the details whether he has got an insurance claim in for that, which could possibly help us? But probably the insurance agent has different kind of insurance used to cover for abandoned uninhabitable property.

When we were burgled Christmas Eve the house looked lived in as it was 'dressed' for selling and we have the estate agents photographs to show this, there were books on tables, cups on sides etc that kind of thing, so it didn't look like an abandoned house - there were curtains, carpets, furniture etc etc. - ahh here's pictures http://www.rightmove.co.uk/property-...-43609568.html so its not like it was easy, I reckon they were trying to nick Christmas pressies, they had to move furniture and carpets etc to get to the pipes (see attached pic)

So next step complaint to NIG or UK Insurers. Waiting for copy of policy document which I should get tmw so we can spell out the clauses they are relying on (though they don't mention them in this letter)

Anyway - here's the letter

--------------------------------------------------------------------------------------------------------------------------

I refer to the above and confirm that I have now received Insurers formal instructions in respect of this matter.



The Underwriters have looked at this case and have concluded that the intention of the insurance contract is that the property must be "actively used" in the context of the product that has been purchased. As this is a landlord policy, this means that the property would need to be occupied by a tenant to validate the "actively used" statements.



It is also noted that the claim itself is for theft and extensive internal repairs resulting from the thieves stripping out electrics, copper pipework and anything of value from the premises.



Insurers conclude that it would be extremely unlikely (unless perpetrated by the tenant) for this type of loss to have occurred had the property been tenanted. Therefore, the non tenanted nature of the property is material to the loss.



Under the circumstances, our Principals confirm that the loss is to be repudiated and we confirm that our Principals are unable to be of any financial assistance to your client in this case.



Should we not hear from you or your client within the next 14 days, we shall assume the position to have been accepted.



No doubt should your client wish to appeal the decision directly to Insurers, then we they will need to follow the formal complaints procedure contained within the policy documentation.



In the meantime, should you have any queries please do not hesitate to contact us.



Kind regards


-----------------------------------------------------------------


after pic

[enaid]

Re: Insurance company refusing payout after burglary

The Underwriters have looked at this case and have concluded that the intention of the insurance contract is that the property must be "actively used" in the context of the product that has been purchased. As this is a landlord policy, this means that the property would need to be occupied by a tenant to validate the "actively used" statements.



Vacant or Disused
Buildings or any part thereof that have become unoccupied,
untenanted or which have not been actively used for a period
of more than 30 consecutive days.


I can see that being neither use or ornament to a landlord, what if tenant did a bunk and you didn't find out until day 31, that too would make a no claim conclusion.

[Amethyst]

Re: Insurance company refusing payout after burglary

The Underwriters have looked at this case and have concluded that the intention of the insurance contract is that the property must be "actively used" in the context of the product that has been purchased. As this is a landlord policy, this means that the property would need to be occupied by a tenant to validate the "actively used" statements.



Vacant or Disused
Buildings or any part thereof that have become unoccupied,
untenanted or which have not been actively used for a period
of more than 30 consecutive days.

Is it normal (I don't know such things) for landlords to inform their insurance company everytime a tenant leaves and they prepare it for the next tenant then?

[des8]

Re: Insurance company refusing payout after burglary

First question: as you are awaiting policy docs do we understand you never previously received them?
second question: (follows from first) when was this policy first effected?

Comments: their intention might be one thing, policy wording might be something else.
Don't get me started about new fangled "intermediaries" who have forgotten that a broker's primary function is to act for his client, the insured.

Having said that, I agree with insurers that a house left unoccupied is a change in a material fact, when it was previously stated to be occupied (do you have a copy of the original proposal?).
However the circumstances you explained, of renovation, constant visiting, house dressed for sale are IMO a good reason for not realizing the risk had changed and bringing into play the ABI policy mentioned above.

[MissFM]

Re: Insurance company refusing payout after burglary

Is it normal (I don't know such things) for landlords to inform their insurance company everytime a tenant leaves and they prepare it for the next tenant then?

I'm afraid it is (normal) and that this is their get-out - ie it's not that the house was untenanted but that they weren't informed of this (usually if informed they just continue with the cover, almost regardless of how long, especially if renovation/building work is taking place).

Really sorry to be a bad fairy

As Des says above, your best bet it to somehow provide evidence that it wasn't, in your view or in fact, unoccupied. Did you, during this period, ever (for example) stay overnight there?