Claim declined as leak damage is regarded as ongoing.

[Clenched Buttocks]

A neighbour of mine has suffered leak damage from her upstairs bathroom. Unfortunately a small damp stain was initially noticeable in the wall of her ground floor living room, below. She thought that this might be coming from her next-door neighbour’s house (terraced property). The neighbour was away for a quite a long holiday so could not be contacted. The leak continued and the damp patch on the wall grew larger but there was no visible evidence of damp from the bathroom. When the neighbour returned from holiday they were able to establish that the next-door property was not the cause.

The damp patch continued to grow, now visible on the ceiling and the living-room carpet was becoming very damp. Also a slight dampness could be now be felt on the carpet in my friend’s bathroom around the WC area. At this point she decided to instruct a plumber to investigate further. In order to pursue this work the plumber had to remove some panels that effectively box-in the WC and its pipework. The walls and floorboards, previously hidden by the panelling, were found to be saturated. The plumber carried out the necessary repair and advised my friend to leave the panelling off as long as possible in order that the whole area had sufficient time to dry out.

Believing that she would be covered for the cost of repairs to the living room wall, ceiling and carpet she contacted her insurers who arranged to have the damage inspected by their contractors. Following this visit my friend waited for the insurer’s response. Amazingly the claim has been rejected on the grounds that the leak was ongoing and the cover does not provide for this type of damage. The insurers position is that the problem would have been evident for some time. This is manifestly not the case as the problem was hidden behind the said panelling.

It may be the case that the insurer’s contractors did not realise that this area would not have been visible at the time of the leak. She will inform the insurers that the panelling was not in place at the time, subject to the advice she had received from the plumber and she will endeavour to contest the issue. Does anyone have any similar experience of this sort of issue? Any comments would be appreciated.

[shywazz]

This should come under buildings insurance, as for the carpet and any other contents claimed for, there should come under accidental cover if your friend has that cover, get her to read the small print in the documentation.
Did your friend have any work done prior to this damage been noticed ? or was it caused due to old piping ? What did the plumber state was the problem?

[gizmo111]

How long did she leave it before she acted? I would think she has a duty to act on it as soon as she discovers it. I also thought that you had to agree work unless it is emergency repairs to make safe with the insurer before work commenced.
I had a pipe that was leaking behind the sink last year, and the estim\ate was that it had been dripping for around 2 years. I called the insurance company as soon as I discovered the water and they sent a plumber and builder round to assess the damage. I had no problems with them paying out at all.

[Clenched Buttocks]

Shywazz: Sorry if this post was placed in the wrong section. I will arrange to have a browse of the policy wording. No, there had been no work done prior to the damage. The plumber describes the repair work as follows:

Providing a replacement retaining washer for the inlet valve to the WC cistern.
The original washer had degraded and therefore was no longer watertight.


Gizmo111: When she discovered the damp patch in the wall she immediately thought it was from next door as she understood that some work to the central heating system had been carried out not long before. As said, she was not able to eliminate this notion until the neighbours returned from holiday. Following this she called the plumber who dismantled the bathroom panelling and found the area saturated. I think it is fair to say that the plumber carried out an emergency repair; though the leak was small over a period of time it has caused substantial damage. No one can be sure as to how long the leak had been apparent; the plumber suspected several weeks, perhaps a couple of months.

Thanks very much for the advice, guys.

[GoldyR]

Under the terms of most buildings insurance policies, you will be covered as standard for resultant water damage caused following a leak from any fixed water or heating installation...in this case a pipe in the bathroom.

As a policyholder, it is a term & condition of the policy to mitigate any loss, therefore as soon as the leak was evident, your neighbour should've acted & had the leak repaired. Most insurers do not cover plumbing costs, it is therefore the policyholders responsibility to get the leak asap & the insurer should then deal with the resultant damage.

However, as you have explained above, your neighbour acted as soon as she was able to, as the property in which she thought the leak originated, was not accessible. Therefore she could argue that she acted propmtly (i.e. as soon as her neighbour returned from holiday) & would've acted sooner had she of know the extent of the dmg behind the panelling.

This is definately worth fightin, as there repudiation is based on very flimsy ground. I would suggest referring to the Financial Ombudsman Service 0845 080 1800 if she doesn't get any joy with the insurers complaints procedure, I am certain the FOS would rule in your favour based on the information you have provided. It is free for the consumer to approach the FOS.

[shywazz]

Hiya still claim for the damaged contents ie carpets etc under accidental damage of the insurance policy.... The rusted washer will be deemed as normal wear and tear, i myself had a small leak due to a washer not doing its job, ie rusted over time, i wasnt able to claim for the work carried out but did claim for the water damage under my accidental damage policy, which in the end covered the work also.
No one can predict when such horrid things will happen, hence paying a few pence extra per wk on insurance could cover for such messy unexpected things. Good luck with everything.

[gizmo111]

Sorry there I misread and thought that she had had the work done replaced the carpets and then claimed.
This will depend on her insurance, and what the policy actually says.
I would guess the next step would be to appeal the decision and then the Insurance Ombudsman

[Bernie_the_Bolt]

I reckon this has been declined as a "gradually operating cause".

The problem is that the repairers have been carried out and the cause of the leak cannot be ascertained.

It's worth pursuing as you may get a goodwill payment but from what I have read the insurers are within their rights. That is not the same as saying that they are right though!

Sorry!

[GoldyR]

They are definately trying to decline it under Gradually Operating Cause, but it is covered under the Escape of Water peril (not Accidental Damage) - as long as she notified the insurers as soon as she was aware of the leak, that is all that can be asked.

The issue in question is that she didn't notify them as soon as she noticed it, hence them trying to decline it as an on-going problem. As long as she makes it clear to the insurers that she acted as soon as her neighbours came back from holiday, & she didn't know it was a leak, they should cover under the Escape of Water peril - all resultant dmg to Buildings & Contents will be covered (as long as she has cover for both). Any self respecting customer focused insurer would cover this as a standard EOW claim, your neighbours insurers are looking for a way to decline the claim, rather than a way to help their customer. With a bit of pressure, they should cover this without question. I have dealt with these types of cases numerous times over the years - having worked for companies that try to decline everything & companies that are doing what's right by the customer....so I know how it works!

[Clenched Buttocks]

GoldyR: That sounds like good advice, Goldy. My neighbour will definitely fight this case.

Shywazz: My neighbour says she will be claiming for the repairs to the wall and ceiling and the replacement of the carpet. She has met the costs of the plumbing repairs and would not have expected this to be part of the cover.

Bernie the Bolt: The term “gradually operating cause” has not been used in any of the insurers correspondence, but I understand what you mean. It would seem to both me and the neighbour that in these circumstances it would have been irresponsible not to have had the plumbing repair work carried out. The cause of the leak can and has been ascertained as the plumber was unequivocal in his report:
Providing a replacement retaining washer for the inlet valve to the WC cistern.
The original washer had degraded and therefore was no longer watertight.
The plumber is also more than happy to give evidence if necessary.


Thanks very much for your advice.

[Clenched Buttocks]

Update.

My neighbour has recently received a letter from her insurance company explaining that they will be rejecting the claim despite our arguments. They have even enclosed a Financial Ombudsman pamphlet should we wish to pursue the matter (which we certainly will). Would you think this is a measure of the companies confidence in anticipating the outcome, is a bit of brinksmanship on their behalf or is it simply normal practice?

Thanks again for any advice.

CB

[revolting peasant]

My reading of this is that the insurers are completely correct to refuse this claim.

Your neighbour has an obligation to exercise reasonable care and from your original post it would appear that she took no steps to ascertain the cause of the damp patch, believing it to be caused by the neighbouring property but you then say that having established that this was not the case "the damp patch continued to grow".

It would be be reasonable for the insurer to expect their client to notify them of a potential claim as soon as it became apparant and to take immediate action to limit any damage. At the end of the day, the damage is as the result of a "gradually operating cause" which your neighbour seems to have done little to limit.

The FOS leaflet is there because the insurers are obliged to inform her of her options in pursuing the claim further but frankly I don't think she has a realistic chance of success.