Do house insurance companies delay in the hope you drop the claim?

Question

I am having problems with my insurance company over what should be a relatively simple claim, and I believe they are delaying things as much as possible in the hope I will give up and go away - is this a common tactic? To briefly summarise: work was done in my absence (in November), and a builder caused a flood - his insurance admitted liability and agreed to pay. My insurance said I should claim through them and to go ahead with repairs which they would fully cover, and they would send damp specialists out. I am still waiting. On complaining, they said they had suspended my claim pending investigation of occupancy of the house - I sent supporting documents, bills and witness statements to show I have a house-sitter and 3 months later, we are no further on. I have faxed, emailed, written and called and have had no response to the claim since December. I am now claiming through the builders insurance. I'm now complaining to the Financial Ombudsman. Anyone had similar experience?

Answer 1

insurance companies have so many 'get out' clauses and whilst they agreed to pay at the time, in future get it in writing and advise them the longer they take to respond the worse the damage therefore the bigger the claim. tell them you will refuse to carry out repairs until you have the letter.

Youll probably find the occupancy question is that in the policy it usually says if left unoccupied for more than 29 days the insurance doesnt cover the house. theyl be looking for the loophole. As for the house sitter, if you didnt advise them of this when you took out the policy, they might say you are renting the property, so landlords insurance is what you should have.

Pull out ur policy wording and have a re read to see if there is any reference to the house being occupied for less than 29 days - make sure it does not say to be occupied by the policy holder or family.

send a letter to the insurance co give details of who u spoke to and what they said, the time you spoke and date and request a copy of the conversation (all have to be taped) Tell them you want a response within 10 working days detailing the progress of the claim and the tape of the conversation. failing that this will be forwarded to ur solicitor. you can pay about £50 for a solicitors letter. all correspondance should be copied, and sent recorded delivery

Write a new letter to the ombudsman again, really complain about the company - try and pick out wording to hold them to a time scale for completing claims, and anything else you can think of and CC the insurance co in stating your responses are ignored and phonecalls never returned. lay it on that ur distressed, out of pocket and annoyed with the whole situation. tell them you are seeking legal advice

basically the hold up is probably due to the underwriters double checking the policy to get out of paying.

they should be recording ALL calls - in case u slip up when claiming or say something that could compromise their ethics, ie you were bribbing the insurance guy for money

you should be ok on the occupancy thing then, make sure in ur next letter you quote it and question  why proof of occupancy is taking so long when statements and proof has been given.

in ur ombudsman letter, tell them you are concerned the insurance company is failing customers in its duty of care. try and find their mission statement/code and highlight anything thats gone wrong. http://www.abi.org.uk/ just hit them with everything. make sure you CC the insurance co on the letter ur sending to the ombudsman

Answer 2

You may have to threaten them with hiring an attorney.  Send a registered letter, return receipt,  with a time for settlement, 10 days, or they will have to direct all coorespondence to your attorney.

You might even pay an attorney to write the letter.  May cost $50-100, but if his services are necessary, his fees can be recovered.

They appear to be trying to use "vacancy" as a reason for not settling.  That may hold for homeowner's insurance, if vacant,  but not for their liability.

Good luck.

Answer 3

In January 2005 Insurance came under the regulation of the FSA which, amongst other things, means that, once you have gone through the insurance company's own complaints procedure you can complain to the FOS. If you have not done that then the FOS will just refer you to the insurer.

If you wish to complain then I suggest that you look at the following:-

The six TCF outcomes

We have defined six consumer outcomes, which explain what we want TCF to achieve for consumers.

Outcome 1: Consumers can be confident that they are dealing with firms where the fair treatment of customers is central to the corporate culture.

Outcome 2: Products and services marketed and sold in the retail market are designed to meet the needs of identified consumer groups and are targeted accordingly.

Outcome 3: Consumers are provided with clear information and are kept appropriately informed before, during and after the point of sale.

Outcome 4: Where consumers receive advice, the advice is suitable and takes account of their circumstances.

Outcome 5: Consumers are provided with products that perform as firms have led them to expect, and the associated service is of an acceptable standard and as they have been led to expect.

Outcome 6: Consumers do not face unreasonable post-sale barriers imposed by firms to change product, switch provider, submit a claim or make a complaint.

These are the 'golden rules' of treating customers fairly.

I also suggest you look here: http://fsahandbook.info/FSA/html/handboo... which details the rules insurers have to go by to handle complaints.

The above should give you plenty of information to submit a complaint to the insurance company.

(Mind you your own insurance broker should have helped and advised you accordingly - you do have one don't you?)

Answer 4

that's always the same with companies like that,they're quick enough when it's you that owe them the money,but if it's the other way about then they basically dont want to know. It may take some time because they always have to investigate what happened and make sure that it's not a false claim ( not that i'm saying it is). Has your builder heard anything from them at all? Phone up the company's head office to complain,and threaten them with trading standards and the TV programme "watchdog", if nothing is done about this.,that may get the ball rolling for you.

Answer 5

Yes!In some in some cases they spin it out a bit!In the hope you will drop the claim!!

Answer 6

I burnt the kitcken table and chairs (dont ask)!and within a few weeks we had our cheque,depends who u are with,but our claim was pretty straight forward.

Answer 7

Some insurance companies are just flakes!!!

The part that sucks here is that they got you to make a claim on your insurance. You should not have done that. If the builder agreed to pay the money and fix the house you should have let the builders insurance company take care of the issue so that your home owners insurance won't go up. The insurance companies will surcharge you for the next 3-5 years because of this.

You need to call your insurance agent and raise a fuss. The agent hopefully will be able to give the claims department a kick in the butt to get things rolling. If you don't get a call with in a few hours to try to resolve the problem start with your agents district manager, then just keep moving up and don't stop until someone answers your questions. You gave proof that the house was not vacant, and therefore satisfied the requirements of your insurance policy. They have to in good faith keep their end of the deal. If they still won't talk to you then you need to threaten to take it to the state board of insurance or whoever is the overseeing authority for insurance companies in your area. If they still won't talk to you then you need to actually make a formal complaint with the state insurance board.

Then change insurance companies!!!!

Answer 8

Hire a public adjuster today.  Your insurance carrier should have paid the claim or denied the claim by now.  Force your company into paying the claim.  Let them subrogate against the liability carrier for the workers.  Your public adjuster can file a bad faith lawsuit if necessary. Do not wait on this ombudsman as they have no power or clout to help you.  Most states have time limits on insurance carriers as when they have to pay or deny a claim.  They will not pay without pressure and yes they are hoping you go away.  By the way 80% or more of insurance claims are underpaid. I have heard that this is as high as 90%.  Somewhere between 30 and 40% of homeowners accept a low payment not knowing they can obtain more money from the carrier.  This is the insurance industry.  They do not make money paying claims.  You need to be pro-active.  Interview a couple of public adjusters and pick the one you like.