Claim declined in full

[rich2644]

Hi, I got burgled in January this year and my claim has been declined in full. They say that the items i listed as being stolen in a phone call made a few days later didn't match up to the items on the "official" claim. This said telephone conversation was not a matter of fact conversation at all. I was just mearly saying that I'd had such and such taken and when are the loss adjusters coming out to see me. It was not a list of things that had been stolen if you understand.

I now have to wait 8 weeks for the appeal to go through. Any advice? Can they do this or are they trying it on?

It's bad enough being burgled without this.

[bed32]

Hard luck - welcome to the club. You will win but it may take a while

The sad fact is that if the insurance company drag their heals there is very little you can do to speed the process up.

It is worth acquainting yourself with the various sections of the FSA handbook that relate to insurance claims, specifically "ICOB" and "DISP".

If you have not already done so make a formal complaint - preferrably in writing - and make it absolutely clear that it is a formal complaint. I would make it plain that you are complaining not only about the decision but also that the way in which they reached that decision was unreasonable. That means that even when they reverse their decision they will still need to justify their actions.

They should acknowledge that in writing within 5 days, and that acknowledgement must include details of their complaints progress.

Eventually they will either have to send you a "final" letter or the 8 weeks will elapse at which time you can take this to FOS - however that will also be a very slow process.

Once you get to that stage I think you should be claiming compensation for the inconvenience and taking it to FOS on that basis. It is important that these companies realise that they cannot delay claims unreasonably

[craigwalton]

Hello,

You say in the telephone call registering the claim you had such and such taken, but it was not a list of items that had been stolen.

Am I right in thinking you are claiming for more than what was originally on the call, or the items in the call weren't stolen and you are claiming for something else?

If it is the former you might be ok. You need to ask whether the Insurers have applied for a police report, and what was on the police report as stolen.

You should be able to get at least what was on the police report and what was originally said.

It also depends on other things - how long after the theft was this telephone conversation. What is the value of the items on the original claim, the police report and also items noticed later?

[rich2644]

Hi, yes it was the former, I told them that I'd had a plasma, camcorder and a bit of money stolen and when was the loss adjusters coming out to see me as I wanted to get the claim moving. It wasn't a matter of fact telephone call, neither was it listing the whole amount of items stolen. I have put an official complaint in so I recon I've got about 6 weeks left of that proccess.

Will I get my money? This along with other stuff going on is really damaging my health.

[rich2644]

Oh. Forgot to tell you that I have supplied all receipts for the items stolen all of which are in my name.

[bed32]

I sympathise with you - I am currently in dispute with Direct Line about a simple stolen/recovered vehicle. The fact that you are in the right does not make the process any less unpleasant.

Yes you will get your money - especially if you can produce receipts.

I suspect that many insurance companies have a policy of refusing many claims on flimsey excuses in an attempt to deter fraudulent claims.

Eventually if the insurance company want to deny the claim they have to be able to prove that the items were not stolen - which they clearly can't if they were.

They may also be able to make difficultly if there is no sign of forced entry into the house - many policies would exclude liability if you left the door open or otherwise didn't take reasonable steps to protect your property.

It may be worth your while submitting a S.A.R, and in it asking explicitly for any recordings that exist of the conversations.

[craigwalton]

I would ring the Insurance Company and ask if they have applied for the police report.

If they have not, then I would ask the police for a copy of the report, and then forward that to the Insurers, (as well as asking them why they have not requested this)

If they have, then ask them what discrepencies are there between the claim form (your exhaustive list) and the police report....

[mooreda]

whose the insurer?

[rich2644]

Hi, yes I've got a copy of the police report already, as have my insurers, and there are no descrepencies at all.

My insurance company is called paymentshield, part of the halifax.

[craigwalton]

Just out of interest, have you had a telephone call with Halifax, where they asked you what you did around the time of noticing the theft?? And then more questions regarding the conditions of the items, etc.?

If not, then as what you are claiming for is on the police report, they have no valid reason to decline your claim. I would write to their complaints process asking for a "final decision for the purposes of the Ombudsman" At this juncture they have 2 options - either maintain the declinature (In which case you go to the FSA, and win) or they will cave and pay.

Good Luck

[Newcastle paul]

Just for the record, I've had a lot of trouble with payment shield, It's a nightmare pinning down who they actually are as the E mail addresses are given as halifax.customerrelations office@uk.royalsun.com I've had a huge complaint about the time taken to address my claim this morning. I followed the complaint procedure and didnt even get a reply, three times in a row. They won't escalate my complaint untill the first one gets through. (Scary how thick some places policies are) We had a back wall collapse into a road which has been blocked for 5 weeks- I'd suggest writing a top level complaint too- as it seems they dont focus on responding. Mention these forums too! Paymentshield - About Us - Management Team Biographies will show you who to E mail, writing is slow when time is of the essence but write AS WELL and record the delivery. The E mail for these execs is (first name).(lastname)@payments hield.co.uk I hope the fact they publicise themselves means that they genuinely want to know about these problems to act on them, Somehow I think i might have something in my tapwater making me a little delusional there though!

[Newcastle paul]

There shouldn't be any gaps in the links or E mails i posted! no idea what is going on there! Paul.