Insurance company choice of words to avoid paying out

[Witsend1]

I recently had a property trashed after I had to put my family home on the market after letting it for several years. I have a landlords policy which covers accidental damage and malicious damage. The claims adjuster flip flopped over the what category of damage could have been done because he thought I wasn’t covered for both. Now he has proof of both and has been dragging his feet over the claim . I contacted the insurance company and they are now coming up with the cause of the damage could have been carelessness by the tenant . There is nothing in any policy about carelessness and I doubt if you could take a policy out to cover carelessness. This appears to me to be a way they can avoid paying out by using this choice of words . How care you legitimately say someone has been careless and caused damage when there are no witnesses. In addition to this the policy has expired and I cannot find an insurance company that will insure the property as I have an ongoing claim going thorough. The insurance company Quoteline direct advise me that they cannot renew the policy with AXA who are the existing insurance company as they no longer deal with them. I am literally at my wits end with this. I am selling the property and had to drop the price by £40,000 because of the damage even thou I am claiming less than £10,000 and I’m worried if the sake falls through I’ll have a property I cannot get insurance for due to the ongoing claim or the ongoing claim will prevent me selling as how can I have insurance on a property if I’ve sold it. Are the insurance company just trying to get out of paying out ? How can they justify carelessness for damage when it’s clearly malicious in some areas and accidental in others ?

[PallasAthena]

I would say that damage caused by carelessness is accidental damage but you'd need to look at any spcific definitions of the terms in the policy.

[des8]

Try going directly to AXA to renew policy whilst claim is being progressed.

[Witsend1]

Thanks. As I have refuted the carelessness claim by insurance company they come back to me with the damage happened over time ! Yes it happened within a few months when tenant knew we were selling property. She kept it immaculate for years but damaged property when she knew she she had to leave. Then we had trouble getting her out. I wonder what excuse the insurance company will come up next Their appointed claims adjuster said all damage was malicious or a accidental , which we are covered for , so how can insurance then come back and say no it was carelessness and then damage happened over time. It’s crazy. I think they just hope you drop the insurance claim. I wonder how long their list of excuses around not paying out actually is !

[des8]

As AXA appointed a claims adjuster perhaps you should remind them of a claims adjusters role!
When I was a broker it was accepted that an adjuster would negotiate claims settlements with the insured and authorize payments.

AXA were never one of my favourite companies and I have in the past had to teach them how to read a policy!

Just keep at them, keep all negotiations in writing or email and if necessary look to the courts for specific performance..

[Witsend1]

Thank you so much. They are really driving me crazy Now they are fully aware I am covered for accidental damage and malicious damage and the claims adjuster has put all the damage into those two categories the insurance tried to say some were caused by careless and when that was disputed by me as nonsense they have now come back and say the damage must have been done over time. Yes it has we gave tenant notice to quit and within 3 months she trashed the place. I am really at my wits end with the insurance company. What do I do next ?

[des8]

You have a choice between the Ombudsman (https://www.financial-ombudsman.org....help/insurance) or the courts .
Neither will be a quick solution, and to an extent both are a bit of a lottery.
Ombudsman works on the basis of "what is fair", not necessarily what is legally correct, but is free to use.

Courts cost initially, but if you win court costs & fees are paid by loser.
Some find the process stressful.

[Witsend1]

What do I do about the tenant removing good quality carpet and replacing it with cheap wood flooring which she incidentally started to rip up when she knew she would have to leave. I would thought it would have come under theft because she took carpets up without asking but insurance company say no , so do I push for malicious damage because she replaced good quality carpet with wood floor and then proceeded to rip that up when she left ?