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Insurance settlement payment - significantly less than quotes insurance have told us to go to ombudsman


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So i'm having a bit of a dispute with our house insurance, long story short, my husband didn't close the shower screen properly and left the bathroom with shower running for a period of time, I walked into my kitchen to find it had all collected into a bubble and burst through a hole in the ceiling causing damage to the walls, floor and plaster.

 

Insurance told us we could claim through our escape of water and had to give them two itemized insurance quotes. We massively struggled to get these quotes with several traders not turning up or wanting to charge a fee to produce them, we asked if the insurance company could send out someone to quote and fix - they said no, we asked for a list of their preferred suppliers and was told they didn't have one. Eventually they told us they would send a loss adjuster out with a view to offer a cash settlement.

 

Whilst waiting for the loss adjuster we had another leak when using the shower and it became apparent that the bath was coming away from the wall when we were using it causing the seal to break and the water to escape down the side, this was confirmed when we got a plumber out through our boiler cover insurance. So we resealed the bath but again the bath would move so in order to prevent more damage whilst waiting for the loss adjuster we stopped using the shower and stuck to baths only. We're still having to do this months later.

 

The loss adjuster came, had no details of our claim as his system had crashed, he spent 5 minutes in the kitchen looking at the hole went into the bathroom, didn't ask us to remove the bath panel or look under the bath. He took some photos and left. We were then offered a settlement of just over £600 out of which a £250 escape of water excess was to be deducted. None of the works included in his scheduled involved fixing the issue with the bath. So we queried it. They've taken our query as a complaint and issued us with a final response claiming the loss adjuster took photos of the toilet which he claims was the root of the leak and we were negligent in fixing it hence as it must have been leaking a lengthy period as evidence by rust on the pipes (our pipes are all plastic so zero rust and 100% never been a leak) so they are refusing to pay out for any bathroom works.

 

We've subsequently had 3 different plumbers out to the house for quote all which have been in the region of around £1700 and all the works listed are the same, all state that no evidence of a leak to the toilet and that significant removal and refitting of the bathroom suite and wet-wall will be needed to remedy the bath issue and the joist which has been soaked along with the fixing of the ceiling and flooring. The insurance company won't entertain these quotes or letters of evidence nor will the entertain the photos i've taken myself of the damage in particular behind the toilet which clearly shows plastic pipes and no rust anywhere there or under the bath. They've refused to let us see the report written by the loss adjuster or the photos taken and refuse to comment on how he could accurately know the issue when he didn't even look under the bath. They wont enter into a dialogue with us and have told us as they issued their final response we have to take it to the ombudsman if im not happy.

 

Does anyone have any experience of this or words of advice on how to approach it with the ombudsman? what more evidence should I need or be gathering in order to support my complaint? I'm quite sure the insurance company are taking the **** in their offer but i've never had to make an insurance claim before so i'm not sure if this is normal or if i'm expecting too much?

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Which insurer?

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Your policy will cover you for the damage caused by the escaped water, it won't cover repairing / replacing the item that caused the damage eg if the bath was not correctly fitted / sealed.

 

If you're sealing the bath yourself or using a plumber, the correct way is to fill the bath with water and then apply the sealant, this means the sealant has enough movement in it to cover when the bath is full.

 

Ideally leave the sealant for at least 24 hours (With the bath full)

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Insurance would not cover the bath coming away from the wall. That is a maintenace issue. For Insurance to cover the bath coming away from the wall, you would need to point to an accident event and claim for accidental damage. The Insurers won't cover water damage over a long period due to the bath not being installed properly. I have a shower in a bath and there is a solid frame built underneath the bath, so it cannot move. I still have to maintain the sealant around the bath every year, as get in and out of the bath, with different water/weight levels does cause sealant to flex.

 

The loss adjuster appears to have made a mistake regarding the toilet pipes leaking.

 

From what you have said, your only valid claim is for the water leak when the shower screen was not closed properly.

 

Can't see a complaint to the FOS getting anywhere. It is simply gaining a settlement for the cost of work, for which you are actually covered.

We could do with some help from you.

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That's exactly how the bath has been sealed, the bath was installed in the bathroom in 2011 and the sealant has been renewed every year by the a plumber as myself and my partner are awful at DIY and there were no issued with the bath moving, leaking or sealant until the massive escape of water due to shower screen door not being closed properly. The last time the bath had been sealed was 8 months before the incident, we kept the invoice from the plumber for it, there isn't any reasonable explanation as to why it's moved after the bathroom flooded but its moved so much from one wall, the wall which the water was running down that when we removed the sealant I could easily get 2 fingers in the gap.

 

The bath has a wooden frame built around 3 sides of it, but apparently it isn't secured to the wall which only transpired after we had the leak and got a plumber out, they also didn't believe it had been a long standing leak as the floor boards under the bath are fine it's the bath frame at one end and joist which have been damaged by water

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I should add, it is possible we might have caused the bath to move when trying to get the panel off when it was flooded. We have a wooden panel which was screwed to the frame and we couldn't get the last screw off from the bottom due to the vanity unit being in the way so we were pushing and pulling and trying to lift the bath upwards to get the panel off, in the end we only succeeded in snapping off a chunk of the rim of the bath and couldn't get the panel off until we got a plumber in who move the sink/vanity unit

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Think you will struggle to evidence the bath movement is down to one water leak caused by a shower screen not being closed.

 

From what you have described, whoever fitted the bath did not do the job properly. My bath is secured by a sold wooden frame on all sides. It is solid and would not move, unless there was an accident involving someone of considerable weight. If the floorboards have not rotted, then that is not the issue. It is bath not properly supported.

 

Get a different plumbers opinion and see what they say,

We could do with some help from you.

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they will pay out for the water damage (ceiling etc) but not for any of the causes as these are maintenance issues. Alo loss adjusters will always find something such as a rusty rivet on a plastic boat being responsible for it sinking when hitting an iceberg. If you can find a rivet on a moulded plastic boat I will buy it off you for its rarity value but they will always put something down to mitigate their fee if nothing else.

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they will pay out for the water damage (ceiling etc) but not for any of the causes as these are maintenance issues. Alo loss adjusters will always find something such as a rusty rivet on a plastic boat being responsible for it sinking when hitting an iceberg. If you can find a rivet on a moulded plastic boat I will buy it off you for its rarity value but they will always put something down to mitigate their fee if nothing else.

 

Like this?

 

https://www.lawgazette.co.uk/law/supreme-court-allows-insurance-claim-even-though-it-involved-a-lie/5056725.article

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