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Claim now denied, having already partially paid out!


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Am in quite a dilemma here, any advice/thoughts much appreciated!

 

Ok, we moved into our house at the end of August, 2007. We took out buildings/contents inc accidental cover with Northern Rock.

 

At the end of September, we came home from a weekend away to find our kitchen floor squelched when walked on - on investigation, we discovered a leak coming from pipework underneath the sink. We immediately reported this to them, they said to get a plumber out which we did the following morning. The plumber duly fixed the leak there and then.

 

We rang the insurers, told them the full extent of the damage, including water underneath the laminate flooring, also water damage to the bottom of kitchen units where water had penetrated - they said no problem, they would instruct their repair contractors to assess the repairs.

 

They arrived a few days later, made their report, took photos etc and say they'll be in touch. A week or so later, another firm arrived, more specialist as the floor and units would now have to be lifted, and dehumidifiers installed to completely dry out the floor. He only carried 1 fan and 1 dehumidifier so he left those and said they would be back in several days or so to begin.

 

Some days later, we then receive a voucher from Northern Rock to cover the cost of replacement flooring. So far so good, at least the claim's been accepted........

 

But then, a few weeks pass and we're on the phone to Northern Rock asking them why the firm haven't returned with the equipment and started work on the floor/units, nor even called us. They tell us several times that they will get them to call us. Eventually when they do, the contractors tell us that due to them only being able to work within a small budget, they'd referred back to Northern Rock. They in turn tell us that they have now instructed a firm of loss adjusters to come round to visit us! (At this stage? After 2 reports done already over 3/4 weeks supporting the claim? After they've already partially paid out?)

 

A week later he arrives. First thing he asks is, do we have a copy of the home survey we'd had done. (I asked why he hadn't been given 1, particularly as our mortgage is also with the Rock and they'd said they would get a copy anyway the very first time we lodged the claim!). Anyway, he sits reading it and then virtually pronounces that - because the report mentions that an area of the kitchen around the sink seems to have suffered from water/damp damage, and that a part of the laminate flooring was damaged and would have to be replaced - our claim was likely to be refused!!! I turned to him and said, are you sure about that? Are you even aware that they have already paid out for the flooring? Well I think he was gobsmacked and he got all flustered, no he was not aware of that!! Anyway, he left after saying the insurers would be in touch.

 

Some 5 weeks after his visit, we have just had a letter from them to say that our claim has been rejected, for the reasons given above!

 

Ok, some advice from people would be good - as far as we're concerned, Northern Rock are just out to save themselves a few pennies! It seems that they were more than happy to initially accept the claim and pay out for the flooring, but when they realised a lot more cost was involved - in lifting the floor, getting equipment in to dry it, taking out the bottom kitchen units, replacing them (they're bespoke units too) - they tried to find a way out.

 

Firstly, as far as we're concerned, it's reprehensible that after receiving 2 reports and the work having begun and the flooring cost long paid for, that only then do they decide on sending out a loss adjuster - how can they do that? Surely he should have been the first person they sent round!

 

Secondly, can they backtrack anyway like that? Yes, sure, if they discover fraud or something like that, but that's not the case. We have been upfront with them from the outset. They would, or should, have seen sight of our survey right at the beginning - they confirmed that in their very first phone call - 10 weeks ago!

 

Thirdly, we would in any event argue that this was not a pre-existing condition at all - the report did not say that this was an ongoing problem. It did not mention any current leaks, and indeed, if the floor had squelched when he was walking on it, I'm quite sure he would have stated so in the report quite emphatically! (If it had squelched when we came to view it, we would not have bought it without querying it!

 

So...they've not asked for the voucher back, and we still have a fan and dehumidifier left here lol. Any suggestions where we go from here gratefully received.

Settled Claims:

Abbey: £4025 Claimed 27/02/06 - Paid in full 19/06/06

NatWest: £4529 Claimed 10/05/06 - Paid in full 1/08/06

Halifax: £1150 lba 18/05/06 - Paid in full 07/06/06

Natwest CC: £420 Initial letter 25/07/06 - Paid in full 08/06

Woolwich: £1100 Paid in full 28/2/07 + Default removed

NatWest Pt 2: £1700 Claimed 10/05/06 - Paid in full 7/2/07 + Defaults removed

 

Current Claims:

Abbey Pt 2: £2300 + adverse credit removal claimed 23/03/07

Alliance & Leicester: £1421 + adverse credit removal claimed 23/03/07

 

Refunds pending:

Capital Bank: Swift Advances: Halifax

 

Son's Refunds pending:

Abbey: HSBC

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  • 1 month later...

House insurance normaly has a get out clause of "they will not pay out for problems caused by bad maintenance" and I guess they will say as the problem was already known about it should have been fixed before it got worse.

 

If I was you I'd just put it down to bad luck and DIY the floor and cupboard bottoms. (get an expert to sort out the plumbling though)

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Definitely sang33ta- I believe the claim would be repudiated on the grounds of 'failiure to maintain', which is a clause in every home/car policy.

 

They are able to backtrack as they are constantly gathering information, and the claim/policy docs are likely to state that should any information arise that means they would not have dealt, they may repudiate the claim.

AB123uk

 

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  • 2 years later...

3/3/2010 - thought I would update this thread as things have finally progressed more than a year later, two years after our claim was rejected!

 

We first complained to the FOS in March, 2009. It took them over a year before they made their first ruling, which basically rejected our complaint. After this, we contacted the original surveyor of our Homebuyers Report who backed us up and essentially accused Axa of misinterpreting his report. Great you would think, surely now after his evidence the adjudicator would review her decision and uphold our complaint. Nope....she again rejected it, as did her manager when we forcefully fought for the decision to be overturned.

 

In September 2009 we made a complaint to the Independent Assessor over bias and delays, he rejects our claim of bias but agrees FOS should pay us £200 for inexcusable delays.

 

In October 2009 we finally prepared and forwarded our final submission to an Ombudsman.

 

In November 2009, as part of a pre-review before Ombudsman, another adjudicator reviewed the file and....upheld our complaint!! He wrote to Axa to ask if they would agree to pay our claim, unsurprisingly they refused point blank and progressed the appeal to an Ombudsman.

 

Yesterday, he FINALLY upheld our complaint too and have ordered Axa to pay our claim - over 2 years since they should have done.

 

Well, the moral to the tale is, don't give up! Frankly the quality of some of the adjudicators decisions is abysmal. I never doubted that once it got to Ombudsman, justice would prevail.

 

Only thing we're peed off with is that for 2 years delay, forced for that time to live in a near squalid kitchen with barely any flooring or base cupboards, he deems the grand sum of £150 to be adequate compensation!!

Settled Claims:

Abbey: £4025 Claimed 27/02/06 - Paid in full 19/06/06

NatWest: £4529 Claimed 10/05/06 - Paid in full 1/08/06

Halifax: £1150 lba 18/05/06 - Paid in full 07/06/06

Natwest CC: £420 Initial letter 25/07/06 - Paid in full 08/06

Woolwich: £1100 Paid in full 28/2/07 + Default removed

NatWest Pt 2: £1700 Claimed 10/05/06 - Paid in full 7/2/07 + Defaults removed

 

Current Claims:

Abbey Pt 2: £2300 + adverse credit removal claimed 23/03/07

Alliance & Leicester: £1421 + adverse credit removal claimed 23/03/07

 

Refunds pending:

Capital Bank: Swift Advances: Halifax

 

Son's Refunds pending:

Abbey: HSBC

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  • 1 month later...

Not sure if anyone can advise, now that our insurer has been told by the FOS to accept and process our claim, which is for a new kitchen, kitchen flooring and decoration (and associated labour), can we insist on a cash payment so we can arrange the work with suppliers and fitters of our own choosing?

Settled Claims:

Abbey: £4025 Claimed 27/02/06 - Paid in full 19/06/06

NatWest: £4529 Claimed 10/05/06 - Paid in full 1/08/06

Halifax: £1150 lba 18/05/06 - Paid in full 07/06/06

Natwest CC: £420 Initial letter 25/07/06 - Paid in full 08/06

Woolwich: £1100 Paid in full 28/2/07 + Default removed

NatWest Pt 2: £1700 Claimed 10/05/06 - Paid in full 7/2/07 + Defaults removed

 

Current Claims:

Abbey Pt 2: £2300 + adverse credit removal claimed 23/03/07

Alliance & Leicester: £1421 + adverse credit removal claimed 23/03/07

 

Refunds pending:

Capital Bank: Swift Advances: Halifax

 

Son's Refunds pending:

Abbey: HSBC

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