Insurance company refusing payout after burglary

[Amethyst]

Re: Insurance company refusing payout after burglary

My parents stayed there for two weeks straight while doing work on it, I never stayed there tho, my house is warmer and about 500 yds away lol.

[MissFM]

Re: Insurance company refusing payout after burglary

My parents stayed there for two weeks straight while doing work on it, I never stayed there tho, my house is warmer and about 500 yds away lol.

It wasn't unoccupied then was it?

[Amethyst]

Re: Insurance company refusing payout after burglary

That's the argument I guess xx

[MissFM]

Re: Insurance company refusing payout after burglary

That's the argument I guess xx

I think you need to "package" the argument a bit

[des8]

Re: Insurance company refusing payout after burglary

If you have no joy with the insurers you might consider going after the "broker".

As insurance is a specialist business I assume you don't have the knowledge to approach the insurance market directly, hence you go via a broker.
The broker acts as your agent to obtain the appropriate cover, and owes a duty to you to assist in making proper disclosure of material facts to the insurer.
They also have a duty to ensure you are aware of and understand the terms and conditions of any policy they arrange for you.
I bet the broker didn't take you through the policy and explain what it meant.
It is unreasonable to expect a lay person to read and fully understand an insurance policy, that is why they go to a broker. A broker has a duty of care to his client to ensure that client understands his obligations under the policy.
I also note that the Key Facts sheet is almost silent on the matter of unoccupancy. The word appears once under "general conditions". It is not part of a sentence & will probably not alert an insured to the importance of declaring it to the insurer.
The same argument would apply to the term "Change of risk"
A lay person would reasonably expect a KEY FACTS sheet to bring to his attention important facts about his cover. I believe the loss of cover due to not advising the insurer of a change is an important fact.

Here's a link you might find interesting about a brokers duties. It is aimed at the professional market but it illustrates what I am always saying about brokers.
http://www.biba.org.uk/PDFfiles/Fore...sforearmed.pdf

[Crazy council]

Re: Insurance company refusing payout after burglary

I would suggest sending them a statement to say ;

that you consider there unreasonable actions and delays are causing you an unreasonable loss of rent and that failing to administer the claim in a timely manor may be leaving your property further open to risk of damage. You consider they are responsible for any further risks to the property during the complaint process.

Add statments from the ombudsman sites and say that you are considering handing it over to a legal proffessional and that if they wish to deal with this without further action, that it should be concluded within 21 days.

Make a statment that under no interpretation was the property formaly unoccupied ( 30 days ), that it was visited regualry and works were being done in the days. If they feel that statment to be incorrect they should provide a statmemt to clarify how there interpritation of the conditions differ significantly enough to withhold payment

Send by registered post.

That should at least stop them delaying you, and may increase the costs you can claim if your forced through the ombudsman and are successful.


As you may realise, i have had to act for landlords over the years in respect of insurance claims. I learned to use their delaying tactics against them. By 2003, i could turn insurance claims around within 8 weeks.

My recent experience ( Fight ) with my household buildings cover, i learnt not to trust there surveyors and shadowed them with independent surveyors ( send them in afterwards ) and did not tell the insurance co i was doing that.. untill the opportune moment.. as soon as i said, should we call in the regulators down to the discrepancies of these two survayors ( i used top structural survayers ), they stopped fighting and paid up

[di30]

Re: Insurance company refusing payout after burglary

You would think the whole point of these insurances for renting/letting should also take into account if at anytime it may become vacant, so tenented or not - that cover should still continue to cover!

I hope this sorts Ame, some insurances seem so unfair and not always made clear prior to you taking on the insurance, its all jargon!

[des8]

Re: Insurance company refusing payout after burglary

Link to back up CC's post 36
http://www.financial-ombudsman.org.u...perties-34.htm

However that still leaves "change of risk"

[Amethyst]

Re: Insurance company refusing payout after burglary

Mr Jonathan Greenwood
The Chief Executive
NIG
Churchill Court
Westmoreland Road
Bromley
BR1 1DP





.......................................

[Amethyst]

Re: Insurance company refusing payout after burglary

6: Escape of Water from any tank apparatus, pipe or sprinkler installation but excluding Damage;
a) to any portion of the Building which is vacant or Disused

Theft has same exclusion


Meaning of Vacant or Disused (Page 5 of the policy booklet)

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

[Amethyst]

Re: Insurance company refusing payout after burglary

Okay - could someone take a look and make any suggestions for improvement to the letter please. Thank you



Mr Jonathan Greenwood
The Chief Executive
NIG
Churchill Court
Westmoreland Road
Bromley
BR1 1DP

cc'd to Woodgate and Clark, Loss Adjusters.

23rd May 2014


Dear Mr Greenwood

Claim Reference xxxxxxxxxxxxxxxxxxxxxx Address xxxxxxxxxxxxxxxxxxxxxxxxxx
Policy Number xxxxxxxxxxxxxxxxxxxxxxxx

FORMAL COMPLAINT

I would like to express my dissatisfaction at both the way my insurance claim has been dealt with and the decision by the insurers not to be of any financial assistance to me following a burglary at the above property.

The property was burgled on 24th December 2013. The perpetrators have been prosecuted and are currently serving sentences. The claim is for extensive internal repairs resulting from the burglars stripping out electrics and copper pipework from the property.

I reported the claim to my brokers on 24th December 2013, Woodgate and Clark were appointed as Loss Adjustors to deal with the claim and attended the property with Mr Alan Barker of Aspray who is dealing with the claim on our behalf on 27th February 2013. We were advised on 24th March 2014 that the claim appeared to be excluded and we responded disputing this decision on 26th March 2014. In the absense of any response we sent a formal complaint to Woodgate and Clark on the 30th April 2014. On the 21st May we finally received a response from Woodgate and Clark informing us of the formal instructions from NIG insurers that the claim had been refused.

We consider that 5 months to come to this decision is unreasonable and the delays have caused us loss, as the property remains uninhabitable and is deteriorating as there is no central heating or water supply in the property. In addition the failure to administer the claim in a timely manner has left the property vulnerable to further damage during this extended period.

The loss adjusters do not quote which terms they are relying on for the insurers refusal to honour the claim only that '' 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. '' we dispute this finding.

The sections our claim is based up are on page 12 of the Policy Booklet.

Clause 6 - 6: Escape of Water from any tank apparatus, pipe or sprinkler installation but excluding Damage; a) to any portion of the Building which is vacant or Disused

and Clause 8: Theft or attempted Theft but excluding Damage; a) to any part of the Building which is Vacant or Disused.

The definition of Vacant or Disused provided within the policy booklet reads as follows; '' Buildings or any part thereof that have become unoccupied, untenanted or which have not actively been used for a period of more than 30 consecutive days. ''

Under no interpretation was the property formally unoccupied or not actively used in the period leading up to the burglary. Following our previous tenant leaving the property in October 2013 it was visited regularly and various remedial works were being undertaken with a view to re letting or selling the property.

We live in Cambridgeshire, however our daughter lives a few hundred yards away from the property. Her and her partner visited every other day to check on the property, collect mail, check the electric usage, turn the heating on and off and empty dehumidifier units that we had in the property.

Immediately following departure of the previous tenant we resided at the property for two weeks undertaking works and subsequently throughout the period we attended overnight on a number of occasions decorating, replacing carpets and replacing furnishings and fittings within the property.

We have a number of receipts from purchases made at that time which I will list below which demonstrate just how active we were at the property. Of course we didn't make purchases on every occasion we visited the property but feel these receipts are ample evidence of occupation of the property during the period in question. We also have evidence of topping up the electricity prepayment meter and of the electricity usage throughout the period.

7-10-13 Wickes (Sutton in Ashfield)
11-10-13 Timpson (keys)
11-10-13 Blueys(dinner)
11-10-13 B&Q (Sutton in Ashfield)
12-10-13 Co-Op (South Normanton)
14-10-13 Aldi (Somercotes)
14-10-13 Asda (Sutton-in-Ashfield)
2-11-13 Electrical tests
2-11-13 Roman Originals (South Normanton)
11-11-13 Tesco (Alfreton)
13-11-13 Carpet (South Normanton)
23-11-13 Iftys News (South Normanton)
3-12-13 Posy Shop (South Normanton)
5-12-13 Tesco (Alfreton)
13-12-13 Co-Op (South Normanton)

These receipts are all for purchases made by ourselves whilst visiting or staying at the property. This is in addition to the time our daughter and her partner visited the property during the period leading up to the burglary.

The property was on the market with a view to selling and potential purchasers were shown around by my ourselves, our daughter and the estate agency staff throughout the period.

The property, at the time of the burglary on Christmas Eve morning, would have appeared to be occupied from the outside. There were net curtains at the windows, the property was fully furnished and carpeted, and the garden was cared for. We suspect that the burglars had broken in hoping to steal Christmas Presents.

We are very disappointed at the long delay and lack of response in dealing with our initial claim and of course very disappointed that our claim does not appear to have been upheld at this stage.

Please review this claim as a matter of urgency and respond within the next 7 days.

Should we not receive an acceptable response we will have no hesitation in taking the case to the Financial Ombudsman Service.

Yours sincerely

xxxxxxxxxxxxxxxxx

[MissFM]

Re: Insurance company refusing payout after burglary

Good letter, Ame. If it were me I would perhaps emphasize that it was never "unoccupied" earlier on in the letter and also stress the consequential damage (to their dragging their feet) a little more. I would certainly bring in the second burglary and underline the part that their tardiness has played in that.

eg:

Under no interpretation was the property formally unoccupied or not actively used in the period leading up to the burglary. Following our previous tenant leaving the property in October 2013 it was visited regularly and various remedial works were being undertaken with a view to reletting or selling the property.

Loose suggestion: The property has never been "unoccupied". It has been continuously "occupied" by ourselves and members of our family. It has been actively inhabited both as a family residence and under our active round-the-clock care whilst in the course of renovations, including during the untenanted period in which the burglary took place.

[des8]

Re: Insurance company refusing payout after burglary

You get your point across just fine.

If the second burglary caused no further damage I wouldn't mention it, as it will only give them the opportunity to muddy the waters. If you have made no claim following the second event your insurers are not concerned anyway. Loss of salvage operator's equipment is not your loss (unless you had agreed to be responsible for it!).

Wonder if they will come back with the argument used in post 16?

[Amethyst]

Re: Insurance company refusing payout after burglary

Yeah, I thought I wouldn't pre empt it in case it was just an off the top of their head argument over the phone.

Thanks for having a look MissFm and des8 - I really appreciate your help. xx

[des8]

Re: Insurance company refusing payout after burglary

Although the NIG might say this doesn't apply to business insurance you should find this an interesting read:
http://www.legislation.gov.uk/ukpga/...tion/3/enacted.
Bits 2 d & e and 3 are particularly pertinent.

I left the ins industry about 30 years ago and am now having to bring myself up to date with current legislation.... hence the delays & breaks in posting:grin: