Insurance claim water leak

  • Thread starter michael1969
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michael1969

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Any advice on insurance company refusing to accept liability on water leak claim damage as it is an operating ongoing leak they say and not a burst pipe causing the damage so they are not accepting liability any route to take as a mediator / representative to act on my behalf etc solicitors can be very expensive!!!!!
 
What do the terms & conditions of your policy say about leaks and exclusions in this context? Are they correct in saying that it's an "operating ongoing leak" (whatever that means) and that this is excluded under your policy? If they are then you'll just have to foot the bill for repairs yourself.
 
The insurance company have already employed one loss assesor on their behalf who only briefly looked at the damage and have declined the claim without even investigating it fully. Just responded and said it is not a insurable peril and we can be of no further assistance and are closing our files accordingly, nice helpful guys, employ a third party to try and avoid paying out the claim at any cost, going to insurance ombudsman is of no use really as he was initially set up by the insurance companies if I am right
 
The original insurance ombudsman was funded by the insurance industry but, as far as I know, was always a statutory body. Certainly [broken link removed] is an independent, statutory body. However I don't necessarily see that you have a complaint to bring to them yet. The terms & conditions of your policy could well exclude this incident in which case the company is correct in refusing to cover it. In addition, before you go to the FSO you need to exhaust the individual company's complaints process and get a final response letter when they are done with it.
 
Thanks clubman for rapid response will proceed to exhaustion stage and see how I get on, I am the little fish in the big pond.
 
Did you check the terms & conditions of your policy as I suggested? If there are exclusions in this sort of area (leaks) then is this specific incident excluded? If so then you are wasting your time pursuing this and you would be better off moving on, putting it behind you and making sure that next time you buy insurance the cover suits your specific needs.
 
it is a very grey area, the exclusion states a water leak from a water appliance is ok but any other not accepted, and as the loss assessor only looked at the damge caused by the water and not checking origin which nobody knows as yet without taking up floor and pulling down underneath ceiling to invetigate and trace where the water is coming from how can they say it is not an insurable peril, I am sure their employed loss adjuster is paid well enough to try and avoid accepting claims if they can at all and justify their existence. I think I have a case to request them to investigate and trace the cause fully and for the insurers to pay a contractor to do this under the policy and then when found make a judgement as whether it is insurable or not but by just sending a letter declining the claim and closing their files accordingly is not good enough answer for a genuine policyholder and customer.
 
Your correct, the Insurer employs the loss adjuster. As RS2K mentioned above you would be well to appoint a loss assessor who will represent your interests. These guys tend to be ex adjusters,all know each other and the approach to take with interpretation etc. They will usually work on no win no fee and charge about 10% of claim, depending on the amount. Ombudsman/Financial regulator will be a bit of long process in my opinion.
 
I would agree with the suggestion to get in touch with a loss assessor. They deal directly with the ins. company and you don't need to get involved. They charge 10% it is well worth it as they tend to get a better deal out of the ins.co. than you would on your own. I used PCD (Property Claims Direct) in the past and found them very good. Plenty others in Golden pages too.
 
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