Hi everyone,

I made a claim for subsidence damage to my garage in 2011. The insurance company after much faff, unprofessionalism and time wasting eventually refused my claim as they said the damage was pre-existed when I first purchased my house (which was over 10 years ago now). Anyway, they haven't got a leg to stand on with regards to that - my entire street is suffering subsidence damage to their back garages caused by a lack of maintenance from the adjacent railway station. Everyone will attest to the fact that the damage started in 2011 - possibly 2010 but not before.

Anyway, I did complain to the Insurers but they stuck to their decision to refuse the claim. I eventually wrote a very long letter to the FOS including everything - all the emails, a transcript of all the visits, photos, mortgage surveys (2 of them as I re-mortgaged), a letter from the surveyors etc. However, because the date of the last response from the insurers was the 4th of Dec 2012 and I only submitted by complaint to the FOS in Nov 2013 - they are unable to look into it. I had 6 months in order to refer the issue to the FOS from the 4th Dec 2012, as I did over over 11 months later, the FOS say their hands are tied.

The reason I didn't write the letter sooner was because I was pregnant, 3 months pregnant at the time. Most of the stuff I needed to provide in the application - photos, surveys etc were in my garage and I couldn't go in there because it was practically falling apart and was (and still is) a real safety hazard. I had had two previous miscarriages late in my pregnancies so I was told not to stress or exert myself at all this time - so I didn't. I just couldn't take the risk of something going wrong again.

When I spoke to the FOS, they told me that even if I had phoned them in that 6 month period that would have been sufficient for them to investigate my claim. If I had known that, then I would have certainly have done that - that wouldn't have cost me anything at all. However, when I looked at their website - I saw that I needed to write a very long application form and supply all documentary evidence for them to start looking at my claim, for that reason I waited until I was well enough to do so.

The guy at the FOS said that he could look into my case, if there were exceptional circumstances. In my head my failed previous pregancies, the risk of endangering my current pregancy was exceptional for me. Obviously not so for him. As such, there's nothing they can do.

1. Do you think I can make a case that being pregnant and undergoing hospital treatment (at St Georges) counts as exceptional circumstances?

2. What further recourse do I have if the FOS don't investigate my claim?

I have until end of this week to reply to the FOS before they close down my request completely.

All help/advice welcome!!

Many thanks

Spanner

The 6 month rule was agreed I believe when the complaints system was agreed, between all the various parties. Given the reasons for the delay, I would agree with you that the FOS should treat you as an exception.

If the FOS don't, there is nothing stopping you making a new complaint to the Insurers and if after 2 months they don't resolve, you can thne pass the complaint to the FOS.

Or you can start a county court claim against the Insurers, but that could be quite expensive if using a Solicitor. You would still need to enter into pre-litigation communications with the Insurers, before you could issue the court claim.

I didn't think of that ... is it as simple as making a second complaint to the Insurers? Will they not just say, we're already replied to this - case closed?

I didn't think of that ... is it as simple as making a second complaint to the Insurers? Will they not just say, we're already replied to this - case closed?

Yes you can make the same complaint again and the Insurers cannot just close it down saying that they have already dealt with it. If the subsidence issue remains and the Insurers refused to deal with it, you still have a legitimate complaint.

Remember that the FOS complaint part is a continuation of the complaint you made to the Insurers. When there has been a 6 month gap between Insurers final response and you contacting the FOS, the complaint is seen to have lapsed.

I've just read the link on the FOS - have to say I'm inclined to agree!!! Their response to my situation was totally dismissive! However, I need to find a low-cost route to resolving this. If I did go to county court and lost (unlikely with the evidence I have but still a risk) would I have to pay the Insurer's costs?

That's brilliant UncleBulgaria67!

I'm going to re-send an updated version of my complaint to the insurer in that case - and take it from there

For the FOS, is it worth pursuing this with them - I have a few days in which to respond to them. What I would like to ask them is: What's the definition of exceptional circumstances? Is it worth going to my MP at all?

That's brilliant UncleBulgaria67!

 

 

I'm going to re-send an updated version of my complaint to the insurer in that case - and take it from there

 

 

For the FOS, is it worth pursuing this with them - I have a few days in which to respond to them. What I would like to ask them is: What's the definition of exceptional circumstances? Is it worth going to my MP at all?

The FOS will try to bat away as many complaints a possible, as they are not resourced enough to deal with the complaints they receive. I doubt that they will continue with the complaint, so far after the 6 months or will take ages before they did agree.

You would be aware that any new complaint via the Insurers and then the FOS will take ages to resolve. Not unknown for complaints to take 2 years or more. For this reason, many people choose to go down the court route and get a Solicitor to help them.

I see no reason why you cant ask the FOS to look at the situation due to the exceptional circumstances !

Did the Insurer advise that you only had 6 months to escalate to the ombudsman when they provided their final response ?

The insurers did state that I had 6 months to refer to the FOS in their last correspondence. I did in fact check the FOS website straightaway, but saw that I needed to complete a full application form with supporting evidence etc, which is why I delayed. There was no way I was going in my garage until I had my baby. The whole letter took about 6 weeks to put together.

I'm so incensed by this situation - I can't really afford a solicitor to go to court, and even if I'd be scared of being completely pulverised by the insurer's legal team both legally and financially! In my new complaint to the insurer's I'm going to submit a link to a youtube video which I'm going to put together showing the damage and showing the subsidence damage caused by the railway, then I'm going to post it EVERYWHERE. I'm going to include a letter from our MP - surely the council need to get involved if the whole street is affected....

I fear as you say that going back to the FOS will take years to resolve. The garage won't last that long. The guy at FOS said that this damage was the worse he had seen in 14 years, just before he told me he couldn't take on the case!

The insurers did state that I had 6 months to refer to the FOS in their last correspondence. I did in fact check the FOS website straightaway, but saw that I needed to complete a full application form with supporting evidence etc, which is why I delayed. There was no way I was going in my garage until I had my baby. The whole letter took about 6 weeks to put together.

 

 

I'm so incensed by this situation - I can't really afford a solicitor to go to court, and even if I'd be scared of being completely pulverised by the insurer's legal team both legally and financially! In my new complaint to the insurer's I'm going to submit a link to a youtube video which I'm going to put together showing the damage and showing the subsidence damage caused by the railway, then I'm going to post it EVERYWHERE. I'm going to include a letter from our MP - surely the council need to get involved if the whole street is affected....

 

 

I fear as you say that going back to the FOS will take years to resolve. The garage won't last that long. The guy at FOS said that this damage was the worse he had seen in 14 years, just before he told me he couldn't take on the case!

This sounds like an ideal case for Dominic Littlewood who presents the BBC programme Don't get done, get Dom.

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