The Hard Case
Even an insurance claim that may seem straightforward at the outset can become a nightmare for you as the insured. Insurers and their representatives can create many obstacles, and even refuse payment of a claim on grounds that you may find illogical and difficult to understand. If instructed at an early stage, we can avoid these problems, but if your claim has already been refused, we may still be able to have it reinstated. If we believe the terms of your policy indicate your claim should be paid, we have the knowledge and experience to collate all the available information on your circumstances, seek case precedents and if necessary take your complaint to the Financial Ombudsman Service.
In one instance, Assessing Direct was instructed to assess damage to a property in Staines close to the river. Floodwater had risen up in the basement of the house: the structure and contents were saturated. Pumping equipment was brought in and subsequently dehumidifiers were installed. Insurers' initial refusal to deal with the problem was based on a judgment in the case of Young v Sun Alliance (1977). A later ruling in the case of Rohan Investments v Cunningham persuaded insurers that they should deal with the claim.
A similar situation arose at a retail shop in East London. At the beginning of January flooding occurred. It took two days to pump out the floodwater. Insurers’ reaction was to reject the claim on the basis that a flood had not taken place. Assessing Direct was able to have the decision reversed, and to the satisfaction of our client the claim was paid.
Other problems have arisen concerning theft from private homes. Assessing Direct has been able to have claims reinstated although insurers had rejected them in the first instance. An example of such a repudiation was on the basis that windows that to all intents and purposes were totally inaccessible, were, according to insurers, accessible and not locked. Another reason for refusal in the case of theft may be a seeming lack of evidence that items, such as jewellery, existed. In such cases we have helped clients collate information that can help them prove ownership, even if the item in question was a gift or family heirloom.
If your claim has been rejected, please still feel free to contact us, as it may be possible to have the claim reinstated. If you have only recently suffered a loss, our involvement from the outset is critical in avoiding such delays and the associated grief.
Stories
Water Damage
Read of our success for the Hartley-Mills family against insurers after water damage at their home.