# Insurance company will not pay



## chiurce (3 Dec 2008)

Hi All

I am insured with Sertus. I have a leak in my roof which I reported to the insurance company. They appointed a loss adjuster from the company OSG. He came viewed the leak from the inside, took a photo from outside.
He asked for a builders report and quotation to process the claim.
He cleary told me that there would be no problem and that I was insured for the damage.
I submitted a quotation from a roofer to repair the damage but the information about the cause was not attached. The representative from OSG called the roofer and suggested to the roofer that the damage might be caused by wear and tear. (The roof is only 10 years old, what wear and tear?). My roofer did not agree, but the OSG rep claimed he did. There are quite a few broked ridge tiles but the adjuster was not interested. He had an ajenda which was to dismiss the claim. He has informed the insurance company not to pay.

What can I do?


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## Romulan (3 Dec 2008)

You could engage your own loss adjustor and have them negotiate with the insurance company on your behalf but they will charge a fee.

You may not feel it worth the cost (its unclear the cost of repairs)

Have you escalated within the insurance company - look to speak to the Claims Manager?

Have the company written to you outlining their reasons for refusing the claim?

BTW I had a similar issue with a leak in the roof.  I did not report it immediately and by the time I tracked it down, insurance company would only pay out if they could track it to a "bad weather" date.  I ended up covering the repairs myself.


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## EASTCORK (3 Dec 2008)

First question - what is roof made from {felt on timber of torch on felt or concrete of fibre glass????}
Second question - did you complete a proposal form - have you got a copy or can you get a copy
Third question - what caused the leak??? did it appear over time or was it sudden??
Fourth question - why are there broken ridge tiles on your roof? is the property in poor repair or in need of maintenance??
Last question - what is policy excess ?? what did the builder state was cause of leak???


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## Ed054 (4 Dec 2008)

I am a loss assessor and I handle property damage claims on behalf of the policyholder.
I would suggest that you look in the Golden Pages and get an assesor in East Cork (if that is where you are based) to handle the claim on your behalf.
Generally flat roofs have a limited life spam and if the cause of loss is wear & tear is not covered.


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## chiurce (4 Dec 2008)

Hi thanks for your replys. Some more info.
I am in Wexford.
The leak is in a valley of a standard style roof approx 45deg. Slates.
Ridge tiles were broken by guy fitting chimney cowel (Only person to be up there about 6 months ago)
Surely this is accidental damage? (I am covered for this).
My excess is €250.
My builder was not sure of the exact cause, but said it could be coming from ridge tiles. I never got a chance to submit a builders report. The loss adjuster claimes the roofer said it could be from wear and tear. (Not true).
The cost of repair is high (1500-2000) as the valley board half way down will need to be replaced.
OSG sent me a letter telling the insurance company not to pay.
I have not contacted the insurance company yet.

Thanks


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## Ravima (4 Dec 2008)

if tiles were broken by 'guy fitting cowl' then why not go against him and his insurers for the damage?


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## homeFixer (19 Dec 2008)

Give this company a call.  Insured Repairs insuredrepairs.ie.  They do the whole service, loss assessment, claim handling and carry out the repairs.  Also, the previous post has a point, if the builder has his own insurance, he is liable to guarantee the works for at least 12 months.


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