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Sorry if it's a bit long-winded, but I need to explain so that advice can be given.
Basically, we're being given the runaround by our insurance company. We had a water leak in our bathroom before Christmas, which seems to have been a slow, long term thing. Hot water pipe to the bath taps is the culprit. The floor in our bathroom is ruined due to wet rot in the joists, and over time the leak has pooled water along the ceiling on the floor below causing it to droop in the living room and utility room. In addition, the plaster appears to have lifted from the dividing wall between the living room and utility room, on both sides of the wall.
Initially, the insurance assessor identified a completely different thing as being the cause, namely a loose waste pipe from the bath plughole. As we had been away visiting family for a week or so, we wondered how a bath not in use could have caused the damage so we got a plumber in who found the actual cause - the hot water supply to the bath. Plumber sorted the leak, but suggested we get the ball rolling and get some quotes in for the repairs, which we did x3. They were all in the region of £3000, and included new ceiling in living room & utility, new bathroom floor inc. joist repair, replastering walls.
The first sticking point was the loss adjuster's point blank refusal that he could have been wrong. This took about 6 weeks to sort out, but eventually someone else came out and agreed that the HW supply was actually the problem. The loss adjusters then took issue with the quotes we'd obtained and pressed us to cash settle for £800. We told them if they thought they could put everything right for £800 then they were welcome to. They then spent another 6 weeks trying to get us to cash settle, upping their offer slightly each time and ending on £1600. We told them we would prefer to have their people in to fix, as there is no way £1600 would cover the costs given the rates for contractors in our area.
After some to-ing and fro-ing, a contractor was appointed, and in mid-March they came out, gutted our bathroom and promptly disappeared. This is the position our house is in at the moment: no bathroom. After no contact for about a week*, we phoned the insurers who told us the contractor had requested a rot specialist check the bathroom floor joists. Specialist came out, agreed the damage was most likely as a result of a long-term water leak and that he'd have the report to the loss adjusters by the end of the week. After another 2 weeks of us trying to push things on (and with absolutely zero contact from insurers) we found that the rot/joist work had elevated our claim to "high-value", so a new loss adjuster was taking over. As part of the rot specialist's recommendation, the room adjacent to the bathroom (our bedroom) should have the floor lifted to check the condition of the joists there, and this extra work was part of why our claim was elevated to "high value". 7 weeks later on, again after zero contact from the insurers and only as a result of our phoning them, we've been told that the joist work isn't covered and we'll have to pay for it ourselves. This is despite being explicitly told that the joist work "was" covered and was the reason that our claim was elevated.
They basically said that the insurance will cover lifting the floorboards to check the condition of the joists, but neither the joist repairs nor the replacement of the floorboards are covered and we'll have to pay that ourselves.
I'm just wondering where we stand, as complaints to the insurers and the loss adjusters are getting us nowhere, and we've been 5 months since the claim was raised and 2 months without a bathroom. The bathroom bit I find particularly unacceptable, but we don't appear to be able to do anything about it other than register our annoyance on a weekly basis.
Any advice would be much appreciated.
I would upgrade from weekly complaining, to daily for a start.
Who are you insured with ?
Esure.
What I can't get my head round is wanting to do exploratory work to see if joists in the adjacent room have been affected whilst at the same time saying we'll have to pay for making good that exploratory work and any damage found as a result. Surely by asking for the exploratory work you are accepting that damage may have been caused by the leak. If so, why is it not covered?
The only thing that rings alarm bells for me, is I thought that slow. gradual type things were excluded from most policies, probably for this reason. I assumed a water leak would be included in this but perhaps its more towards woodworm etc.
However, it seems they've missed that 'opportunity' as they have identified its a leak over time. Raise it with the insurance ombudsman people? Check small print to see whether they exclude long term/gradual damage.
You need to go through Esure complaints process before you can go to the ombudsman. However because this is taking forever I assume you already have an official complaint in and you can say what step of their internal complaints procedure you are at. Whinging to the call handler isn't an official complaint by the way.
^^ this
Follow their complaints procedure, which involves complaining by letters and so on. Moaning to a call handler won't help at all sadly. Seems unacceptable from what you're saying.
I would tend to argue no bathroom for that length of time means job sorted asap or you seek alternative accommodation and bill sue them for that.
As others have said follow the complaints procedure and then if needed ombudsman, if you don't follow that the chances of 'suing their asses' is slim.
When I was having non-communications issue with an insurer before Christmas, I rooted out the details of the insurance companies MD and sent him a strong e-mail directly.
Claim sorted in the same week with no haggling over value, (though that was fairly small compared to yours) then followed up with a £50 check and apology letter. That might be worth a try.
You have my commiserations over the messing about though.
That does usually work to be fair - I had an Amazon issue sorted quick sharp by emailing the MD. Certainly works here too - I've been involved in the "sort this out before there's a complete shitstorm" aftermath!
follwo their procedure and then threaten to take it to the FOS. whatever the outcome of this it will still cost the insurer the best part of £1k to go through this procedure so they may in fact just decide to pay out.
check the terms and conditions that came with you policy as well. i had a similar issue with my insurer over the theft of my dh bike. upon the advice of fellow STWer Dannybgoode...i did the same and they quickly settled for the sum insured and paid compensation on top of that.
if you need to write a letter to them i have the original template you can use. email in profile
We've already made an official complaint, but still have a few weeks to go before we can take it to the Ombudsman.
I've spoken to the insurers again and their stance is that they won't pay for any damage to the joists in our bedroom that aren't as a result of the leak. Fair enough. I'm now hedging my bets that every joist in the bathroom from the point of the leak to about 8 foot away being covered, but damage to joists in the opposite direction somehow being attributable to something else.
Oh well... And still no date for start of works.