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Insurance won't pay out and now accusing us of fraud!!! HELP


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We recently had a flood upstairs and our downstairs room was destroyed. We've had no claims insurance for more than 10 years.

 

We put in a claim to our insurance company who were dragging their heals ( like they do) they came and asses the damage and we thought the claim was going through. Then out of the blue we were sent a letter by a different insurance company stating we had to renew our policy.

 

My husband had insured is twice by accident for home and content insurance!!! He called the other insurance company and told them about the flood - they asked if we had any other insurance company and he said no, but he wasn't really listening to the questions properly either. Straight away they stop all claims and sent it to the investigation team.!

 

The same underwriter looked at both cases and the second insurance company said they've rejected the claim due to fraud and the 1st insurance company who took 4-5 weeks to come to this conclusion And informed me today they also stop the claim for fraud!

 

This was a genuine mistake - getting two policies (why didn't they tell us) and not telling each insurance company about each other. He thought they were the same company!!!

 

We now can't get any compensation for £4000 worth of loss....my house is a mess and I've waited 8 weeks for them to come to this decision. With 4 kids running around it's quite dangerous now

 

 

Can anyone help or advise on what to do? Will this effect future insurance? Have I got a leg to stand on at all?

Edited by fkofilee
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I'm trying to unravel the story because I don't think that you have explained it very clearly. Maybe someone else will understand it more clearly than me.

 

Please will you start off by telling us the names of the two insurance companies.

 

I understand that you may have had two insurances providing the same cover. I'm sure that you understand that only one of them would pay out but having two insurances would not of itself be fraudulent. The question is, how many claims did you make? Did you claim from one insurance company or did you claim from both?

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i think the 'rules' allow for a genuine mistake to still be covered, depending on the circs. and if shown so, then they might end up splitting the claim.

as bank says, q is whether it was a genuine mistake

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I think you need to register a complaint with both companies in writing, sending copies of the other Insurance, explaining how you managed to arrange dual Insurance.

 

If you look at this from the Insurers point of view, it looks like you have arranged two Insurance policies with a view to making two claims for the same damage. This is why they think it may be fraud. Also there may be some reasons why they think the water damage does not seem genuine and you have not said why this might be the case. I have come across a few claims where a loss adjuster has found the claim to be fraudulent, because there has been an attempt by the home owner not to tell the truth. They have moved other items into the area where the water damage occured, so they can claim for undamaged items, just to obtain new furniture. They had just put water onto chairs making it look like it was caused by the water leak. They have also attempted to claim for more than the actual replacement cost of items. And they have tried to insist on a cash settlement, rather than Insurers paying to replace items and repair the house.

We could do with some help from you.

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Hi thanks for your reply.

 

The water was caused by a dodgy split washer in the toilet system but because it happen in the night it cause so much damage.

We didn't realise that we had another policy until the renewal turn up.

 

The other claim was going through as normal

- they been out to asses the damage and I'd collected quotes etc.

 

I wasn't bothered about cash pay out I just want my house back to normal.

My husband paid for the second policy on a credit card all in one go and then forgot about it and then bought another policy on direct debit.

 

There was no paper trail on that account to remind us we had it or anything.

They asked if he had any other insurance policies

- he said no....but he thought he meant by them.

 

I know what a div - but he made a mistake and he's not the best listener.

 

we paid two insurance companies and now no one will pay out - grrrrr

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If there is nothing wrong with the claim, then a letter of complaint to both companies addressed to Head of Claims, just explaining what has happened regarding dual Insurance and that there has not been any intention to claim twice for the same value of damage.

 

Usually in this situation, i would expect both Insurers to agree to settle the claim, but they split the cost between them. So if both policies had the same cover, the loss adjuster would split the claim 50/50 between both companies.

 

I cannot see it is fraud, unless they have evidence to support this. Complain to the Financial Ombudsman Service, if they won't agree to deal with your claim.

We could do with some help from you.

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I get the dual insurance mistake, it can be done, but putting a claim into both companies, that takes a bit more doing.

 

Why/how could you do that knowing you have already put a claim in? That is where the fraud angle is coming from.

 

The OP is going to have to have a very good reason to explain that.

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This is the crux of the problem.

 

TO enable us to help you, could you explain how two separate claims were put into each Insurer.

 

It would also help if you could give us rough time scales on when each of the policies was taken out.

 

It may also help if either of these policies were exisiting policies that you had renewed, could you confirm if both policies were brand new policies with a gap between any previous policies or did was one of the policies a cover you had renewed

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do answer the guys' specific questions.

eg bankfodder asked straight off if 2 claims were put in?

you said that he 'told the other insurer about the flood'. do you mean he put a claim into them as well, after the other claim had started?...maybe, as you say above 'the other claim...'

etc

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It needs confirming but my reading was that when told about the flood the second insurer asked if it was covered by other insurance and was told no. It would seem logical that they then started a claim.

Any opinion I give is from personal experience .

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Hi thanks for all your replies I really appreciate it.

 

Judging by the telephone conversation they have sent us

- it's states that my husband was asked by the 2nd policy holder if he'd made a claim to any other company he said NO???!! I am fuming!!

 

When they checked with Claims underwriting exchange he was told you've recently claimed for this with a different company....he said oh " I need to have a word with my wife I was under the impression we had no insurance until I got this renewal letter". he began to backtrack.

 

The 1st policy was taken out in October last year, paid for in full and online.

We have no hard copy of this policy and no paperwork except for the renewal being sent.

 

We then bought another policy bought 4 months later as I remember my husband panicking saying we've got no insurance on the house.

 

My question now is damaged limitations.

The original company that was dealing with it have now also refused to pay out on the grounds of principle of "good faith".

 

I am heart broken, and my husband is feeling pretty foolish.

 

My question now is what can I do....regarding damaged limitation.

They'll cancel both policies and I'll have no inusrance and probably won't be able to get any again either.

 

Is it even worth going to the ombudsman about this...

..the companies themselves have been really shoddy about this,

not returning calls etc - they sent a £20 through as compensation!!!???

 

I've started decorating myself but the floor, well it's a mess :-x

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Sorry I'm new to this and have only just seen some of the threads.

 

The companies are Priviledge and Churchhill.

 

Priviledge paid for by DD every month.

Churchhill paid for in full, online, sent out no documentation.

 

Churchhill accusing us of fraud and have sent out £20 compensation for incompetence customer service.

 

All underwritten by direct group??

Why didn't they tell us we had already had insurance for this property?

Both policies were brand new Churchhill being taken out first and Priviledge second with a about a four month gap.

 

We have a no claims of about 12 years +

Edited by marthafarqua
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Sorry I've only just seen this and just trying to work out how the site works.

 

To answer your questions.

 

The two companies are Churchhill and Priviledge.

 

My husband didn't realise we had two policies until the renewal for Churchhill turned up in the post - this was about 3 weeks after we'd made a claim with Priviledge.

 

I guess he was fuming about having paid a whole year to two insurance companies...

He got on the phone straight away and made a claim with them also...he got busted.

 

 

And all claims void.

It wasn't intentional we didn't get two policies to claim twice for a future mishap.

. just stupid and naive and forgetful.

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If you or your husband did not attempt to deny the other policy then it can easily be interpreted as a genuine mistake. Please make a complaint to the Insurance Ombudsman, they have to provide the ombudsmans details upon request.

 

Do not let them bully you, show them that you mean business and will fight them all the way. ;)

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You are dealing with the same company Direct Line group and they will have access to all phone calls made to them. If they think there has been a deliberate attempt to make two claims for the same damage, then i can't see them budging.

 

All you can do is write to the Head of Claims Direct Line group explaining what has happened and there was no intention to claim for more than the damage that has occured. It was simply believed that after duplicate Insurance was found you had to phone the second company to register the claim and that somehow after this that tne two insurances and one claim would be sorted out.

 

If you want to obtain recordings of all phone calls to them, just send a Data Protection Subject Access Request to Direct Line head office.

 

If you don't get anywhere with a complaint to Direct Line, then take it to the FOS who can investigate it and decide whether it was fair to decline the claims due to dishonesty.

We could do with some help from you.

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I would echo Uncle's advice eg try a letter explaining the situation rather than an official complaint at this stage.

 

Keep an eye on timescales so you don't time out on being able to use the Ombudsman.

 

Try an keep your letter as clear as possible, it may help to include a time line of the events.

 

At the moment your situation will be ringing lot's of alarm bells about fraud, a well written letter explaining what has happened may help them see what actually happened.

 

If there was no intention to defraud the Insurers then you have a valid claim, it will just be a case of explaining this to them.

 

Please don't be tempted to lie as it's likely to be discovered, just stick to the truth

 

It will probably actually help that they are both in effect the same Insurer

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Thanks so much for replying.

 

Do I need the name of the Head of Claims Direct Line group?

 

Is it advisable to get all access to all phone calls first?

 

Do I CC both policies?

 

Even tho they're the same company?

 

Wish they'd of told me that I already had a policy before I took out another one.

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Just find out Direct Lines head office address and address letter to head of claims.

 

You can ask for copies of calls in the letter.

 

Yes mention both policy numbers, so they can access the records.

We could do with some help from you.

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  • 1 year later...

Many thanks for your help regarding this issue.

 

After a whole year the company has paid out and that was some £4000 worth of damage to the property.

 

I had to go through the OB who said that the company was wrong not to pay out but right to cancel the policies.

 

Its great news to get the money, as I had a no claims of 15 years too,

but I guess the question is now how or where do I go to get insurance for my house ?

 

I've had no insurance now for a year.

 

Any suggestions or companies who would be willing to take me on with a cancelled policy?

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Try Home Protect, Bureau Insurance services. There are many specialise brokers.

 

Search on the BIBA site which is like a Yellow Pages of Insurers.

 

Think you should dispute the Insurers cancellation, as you never deliberately took out dual Insurance to claim twice. If they accept that it was just a mistake, but the cancellation stands, then you need a letter stating exact reason for cancellation. A new Insurers will ask.

We could do with some help from you.

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insuring twice isnt fraud, claiming for the same thing on both policies and not telling then is. You certainly didnt do that. As UB says this makes their cancellation look like vex. They are entitled to say you dont need us so we decline to cover something already covered butan accusation of fraud is just wrong as they can show no evidence of intent. That is what you should push towards in getting something in writing, they certainly wont want to have to justify their actions so will most likely give some generic rubbish reason like you breached their disclosure policies regarding the second insurer.

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