Anyone familiar with water damage insurance claims?

[dollius]

We had a leak from the bathroom in the house we now let out last summer. It was fixed. The plumber looked at the ceiling below and said it seemed secure and he did not recommend taking it down because of the mess etc, and that we may be ok.

It did not occur to me to call in the insurance company at this stage.

Three weeks ago, part of the ceiling below the leak area has collapsed.

Insurer says not covered because I did not give them the chance to assess the damage in the summer. Bloke on phone says it would have been "common sense" to call them in then.

I really had no idea I should have done this.

Is there any point in going any further with this or was I really a total dimwit for not telling the insurer about the leak in the summer?

If anyone with more knowlege about these things could give me their opinion, I would be really really grateful.

It's always easy to say this kind of thing in hindsight.

If you are still with the same insurer I can't see why they can't come and assess it now (if you are covered for this in your policy). I assume your plumber would be able to back up your claim of a leak? I'd be more forceful with them and say you want to make a claim.

However, I guess if you let it out you probably now have different buy to let insurers? They might not be liable as it happended before you took out their policy.

No, we have the same insurer (been with them for years and never claimed until now) and my plumber has already backed me up on the leak issue. It's just that the insurer says I should have informed them about the leak when it happened.

I had no idea I was meant to do this.

Insurer has sent their own surveyor to assess now, and agree that the damage was caused by the leak, but say I was irresponsible not to call them in when we had the leak. Therefore they won't pay.

But I wonder how far you go with that line. Do you have to ring them every time the bath overflows, say? Or there's a leak from the dishwasher?

Really just want a feel for whether most people would be the same as me, or whether it's a case of, Of course you should have phoned the insurer when the leak happened - everyone knows that.

I think personally that the insurers are just having you on. Read your policy docs, is there a time limitation on when a claim can be made.

I ask because we had a v expensive fridge and dropped something in it and chipped the inside. About 6 months later we noticed food was not keeping cold so called the insurance and they came out assessed and settled. They didn't say 'you should have mentioned this when it happened'.

The only thing I suppose your insurance could complain about is you have been negligent - in that you had a leak which you knew affected the floor/ceiling but didn't do any remedial work and so now it has collapsed and you are partially responsible. But this doesn't seem to be the line they are going down.

I expect all their claims dept are being told to scale back claims during the recession. Don't forget you can complain to the ombudsman if you are not satisfied. I'd threaten them with that.

Yes they are arguing that I have been negligent in not calling them to assess whether remedial work needed doing. It just didn't occur to me to do this because the builder who checked it said the ceiling seemed secure. I never thought it would be necessary to take the ceiling down to check it was ok.

I just wonder - does this mean you have to do that every time the bath overflows?

There's not a time limit, just a clause stating you have to inform them of anything that may cause damage in the future. Unfortunately I didn't read the small print and was unaware this meant I had to inform about the leak.

Thanks for looking at this for me.

DH (who does biiiig property claims for a living) says that they are talking b*llocks.

If they wish to decline you would have to have been 'reckless' in your behaviour

You as the insured have a duty to minimise their loss and notify within a reasonable period of time, but if there was no significant visible damage at the time and you informed them within a reasonable time, you have fulfilled your duty.

Ask them to put it formally in writing to you - they have a duty under ICOBS8 to explain to you in writing all the reasons for the decline

This will either result in your case being pushed up to someone who knows what they are doing, or allow you to persue this through the Ombudsman. Note that once they have set out the terms of the declinature, this is binding, and they can't change what has been stated.

He'll be happy to advise further.

I would challenge this too. You have not been negligent and carried out remedial work when the leak occurred. You had no way of knowing that there was further damage as it wasn't apparent at the time.

Tell them if they can't explain their justification in not meeting the claim you will report them to the Ombudsman.

I am ex-insurance but not in this field btw.

Sounds crazy to me too. You have called as soon as you are aware you need to make a claim - otherwise like you say you would have to call them every time the bath overflows!

I have worked with insurance companies and loss adjusters in the past and agree with cmots hubby that they are talking bollocks and imo just chancing their arms.

fair enough, perhaps you should have informed them of the leak (but I can see why you didn't; loss of no claims etc) however I can't see that waiting until the further damage happened has made you in any way negligent. If you had no reason to expect there to be any further damage because you were advised to that effect by your plumber, then you have fulfilled your side of the contract imo.

I hope you can get it resolved

sorry meant to say I have worked with them in the past and know that they will do their utmost to try and mitigate the amount of money that they have to pay out!

Thanks so much for this ladies. I am writing a letter to the head of customer services, which is step one in the complaints procedure and will take it from there.

Don't write a letter to head of customer services at this point - it'll just take extra time, and isn't the most efficient path.

Phone the claims helpline, and say that you have taken advice and would like them to put the full details of their decision to decline in writing - quote their obligation to do this under ICOBS8. If the person you speak to stalls, ask to speak to the supervisor

Good luck dollius - it's good news that your builder checked it and said it seemed secure. Would be worth getting that in writing or at least his agreement to back you up if necessary. From what most people are saying and my experience, it doesn't sound like they have a leg to stand on.

Thanks everyone. I have asked them to put it in writing. And my builder did put it in writing that the ceiling seemed secure, it's just that he added: "in my experience, plaster can break when it dries, but I am reluctant to advise you to take the ceiling down now, as it may be fine."
They are saying I should have taken that as a warning and called them in. Perhaps I should. It just didn't occur to me - I focused on the bit about the ceiling being secure.
I suppose it could be argued both ways, but I have nothing to lose by pushing it. I have, after all, paid premiums to them for years and never claimed and I don't see how it makes any difference. Take the ceiling down back then or take it down now - there's no material difference.

Exactly - you took advice, the delay in the claim has not increased the cost of the repair, and you have not been reckless in this.

Update:

They sent the official letter outlining why they were rejecting the claim, and then today I got a call from their head of customer services (who I wrote letter of complaint today), overturning that decision and the money for the work is being paid to us now. Hurrah!

Thanks so much for your encouragement - it really helped me push this through.

Well done dollius - it's great when you can make this big companies back down.

Thought they would do this.

Very for you.

Hi, was your leak from a pipe?

Its just I am having similar problem, but the person taking down the ceiling says it may be water getting through the tiles next to the bath or faulty sealant around the bath (which I had fixed before the ceiling ever fell down).

Just seen this.
We recently had to make a water damage insurance claim when I came home one day to find water dripping onto my stairwell and landing walls and bedroom ceiling! I immediately called our insurers who were completely useless.
Long story short.
They sent someone to assess it who said claim should be rejected!(Don't know how he could say this as he literally spent 5 minutes at ours and didn't actually go up on the roof).

Weeks later now we had a few roofers and plumbers round. None of who could work out where the leak was coming from!

Tearing hair out in frustration at this point. Insurance company just did'nt want to know.

Then came across a company in london called Allpropertyclaims
who were a life saver!
They dealt with our insurer , got the claim accepted and were able to sort out the repairs when everything was agreed. Saved us a lot of time and hassle.

If you're making a claim for water damage in your property, certainly suggest you consider a company like this. We learnt the hard way that insurance companies are happy to collect your cash but it's a different story if you want to make a claim!