Insurance company refusing payout after burglary

[Crazy council]

Re: Insurance company refusing payout after burglary

Do you mind me jumping in here.

i suggest the second part of this sentence

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

They will just argue with you untill you force them to answer there interpretation. Its sounds like what they said to you was as loose as possible. Tie them down to a fix interpretation of unoccupied for 30 days.

A word of caution. You are dealing with the claims management company on behalf of the insurance co. Dont expect them to have any integrity, honesty, or sense. Its there jobs to knock you down and tie you up with paperwork. MAKE THEM MAKE FORMAL STATMENTS AS TO WHY YOU DONT QUALIFY, then you make your statments, not the other way round, becuase they will just look for any holes in what you say.

Secondly, be cautious of giving them any definite statements, Its up to them to prove your not insured not you to prove that you are. Thats were a lot of people go wrong with insurance claims, they listlen to the CMC ( parasites ) and dont realise that its there job to disprove your claim, not your job to prove it.

[des8]

Re: Insurance company refusing payout after burglary

Be careful of the advice in post 46.as there is a burden of proof is on the insured to prove the loss was caused by an insured peril.
However, in the event of a claim which the insurer wishes to avoid, the insurer has to prove the loss was within the scope of the policy exclusions.

In other words the policyholder must demonstrate an insured peril caused the loss to the insured property during the policy period. If the insurer then wishes to invoke an exclusiion the insurer then must prove the exclusion applies.

It was found in Nulty v Milton Keynes Borough Council [2013] EWCA Civ 15.

that a claimant must demonstrate that the particular version of events that they rely upon is more likely to have happened than not in order for the civil burden of proof to be satisfied.

It is the claimant's job to prove his claim.
If the insurer wishes to avoid the claim, then he has to prove the exclusion.

[Crazy council]

Re: Insurance company refusing payout after burglary

Hi des, i agree with your interpretation, perhaps i didnt explain it clearly

It is the claimant's job to prove his claim.

She has, she has told them that is was not unoccupied for 30 days and has reasonably covered there interpretation, therefore considers she is covered.
And , i further suggested she state

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.

then

If the insurer wishes to avoid the claim, then he has to prove the exclusion.

so the second part of the stament iu suggested

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

should do exactly that, its also clear enough to point out to a judge if they delay things. Asking them to do it within 21 days is reasonable, so is sugesting that all further costs are down to them. I think i just did not explain right.

I have just last year been through an insurance claim with all sorts of difficultys, that streached a number of years, including a period were the property was empty, bankruptcy during claim, possession to the trustees for 2 years, a burglary during that time, and a subsidence claim. To keep the insurance cover that i had for the 2 years i was fighting the trustee but had been evicted by him ( empty house ) . We had to agree the definition of that term with my insurance co, and it is as always has been, unoccupied means unvisited. All we had to do to maintain conditions was send the estate agent in to check it every few weeks. ( i eventually beat my trustee adn reclaim my house am sat in it now typing this)

The insurance co ( and there claims management company ). offered me £ 7500 to start with. I settled at £ 54,000. and, i have just made a large claim against the claims management company ( cunningham lindsay CL-UK ) for all the costs incurred between them 2 figures:tinysmile_aha_t:.

[des8]

Re: Insurance company refusing payout after burglary

Thanks for clarification.
I was concerned peeps might have picked on your 2nd highlighted phrase and blasted ahead.

You've certainly had fun, haven't you:eyebrows:

[Crazy council]

Re: Insurance company refusing payout after burglary

hi, des, totally correct now i have re-checked it:beagle2222:

were i said

Secondly, be cautious of giving them any definite statements, Its up to them to prove your not insured not you to prove that you are. ............. that its there job to disprove your claim, not your job to prove it.

i should have said, when you feel that your claim fits within the general conditions of insurance and is not obviously affected by any exclusions, that you should make your statement with what evidence you have, and then make them prove the exclusion.

I think i read that you used to be in the insurance industry Des ?. Things have changed since 2005, specifically claims management companies that the insurance cos employ. It used to be a fair, and delays were usually genuine as part of the administration of the insurance. Not now, delays seem purposeful to frustrate the claimant, some of the statements and arguments put up by the CMCs are b****s, but, this can work out in the claiments favour if they act correctly.

We did find something interesting during my fight in relation to CMCs, and its there is a gamble/bet. here is an example

Clament makes claim and is eventually accepted ( like i hope the one above will be )
The insurance co then use there CMC and an estimation of total cost of repair and administration by the CMC is sent from the CMC to the insurance co. The Insu co then pay this into the account of the cmc. Lets say for example thats £ 20k
Whatever you accept below 20k, the CMCs get to keep, but her is the gamble for them, if the claim, goes over that, the CMCs have to pay a larger percentage towards the extra amount.

Because of the extremely unusual circumstance of my bankruptcy ( one claimant the local council on flase ct LOs ), and the fact that my assets were large compared to the creditors, ( my morgare is less then 20% sale value of my house and my asset was more than all claims and costs put together ), and specificaly due to the fact that the trustee evicted me down to a statement sent to him ( PWC ) from the CMC that i was delaying the claim, and the judge evicted me for that. Most fo the CMCs actions were put up in front of the judge, and the judge formaly asked the trustee to ask the CMC questions. Upon the first answers, the judge immediately protected my property, and instructed that she wanted to be satisfied that the claims was full, and put the responsibility on the trustee for administration but said ghe could not agree without iether mine of her agreement.

It took me and the trustee nearly 18 month to negotiate an agreed settlement around the insurance issue, and as i said in my forum posts during this time, my settlement with PWC excludes me from disclosing some of the conditions for another 2 years

[des8]

Re: Insurance company refusing payout after burglary

Sorry Amethyst, but going off topic slightly now:wub:

You're quite right,CC, and would know from earlier posts, that I worked in the London Ins markets as a broker.
"In the old days" we acted on behalf of the insured and only received commission from the insurers. If you were good you got the business, otherwise you went hungry:tinysmile_cry_t:. No fees from your client in those days.

I loathe the current attitude of brokers getting paid from both sides, but then not doing their job.
If a broker's client has a loss, IMO, the broker should handle it and FIGHT for his client.

If insurers hand their claims over to a claims handling company who don't handle the claim as claimant feels is correct, the claimant is at liberty to contact the insurer directly and complain.
I found it concentrates their minds wonderfully if they are reminded that it is they, the insurers, who will be sued!

I have dealt with CMCs and fully agree with your comments, and congratulate you on realising that they only work for themselves not for insured nor insurer.

:focus: