This is going to be a very long drawn out case, unless someone can offer some element of hope for us.

We completed renovations to a derelict property about 2 ½ years ago. Our porch needed a new roof which was done with a trocol membrane. In a storm back in January 2016 we returned from a trip to find a metal pole on the flat roof which had a covering of gravel. My immediate suspicion was that it was the remnants of an old tv aerial, but as it was only the pole, I have since found it to be referred to as the mast, not the aerial itself. This is important as it was referred to as an aerial when I rang to make the claim. Because of the gravel I did not notice the membrane had been punctured, but removed the pole and lifted down a bracket/clamp that was on the main roof. In the August of 2016 we noticed a dry rot problem, which had previously been identified and treated during the renovations, had come back with vengeance. I notified the company that treated our house and they began stripping the property apart under warranty to determine the source. It was then that we found the porch roof was compromised which had allowed damp to enter the property.

I notified MoreThan/RSA that the pole was suspected and they sent out Building Validation Solutions. Their "inspector" was quick to dismiss the case, suggesting we would get nothing from the insurance company as dry rot was not covered. It was explained that we were not claiming for the rot but for the porch roof, hall, stairs and landing decoration and vestibule door due to the leak, and that everything else was being covered by the rot company. BVS suggested to decline the claim due to rot, but yet some three weeks later, agreed inadequate costs and issued a scope of works for a patch job with inferior materials than what was listed on his first report to insurers.

After rejecting this, RSA sent out their own senior loss adjuster, from a fraud unit??? who took a statement and agreed that BVS had not conducted themselves correctly, and asked for estimates for the repairs. These were for different aspects of work, building, plastering, decorating plaster moulding etc and as they were emailed to him, he agreed them individually by email. Over a couple of months, he was aware we had begun the works as it was nearing Christmas and we had a lot of work to do to rebuild our home. 5th December he sent an email giving his account of what he had agreed "as he saw it" and was going to transfer funds. This was an inaccurate figure as he had forgotten to include some aspects of work he had previously agreed to, but after a quick couple of emails he accepted. At this time I had asked him to consider the exterior rendering of the front of the house to match the new render of the porch at our builders request. This went over what he was authorised to pay and he referred it to in house specialists due to escalating costs. We have been fighting ever since. It is worth noting that this loss assessor was happy that we were being fair and reasonable with regards to the claim, considering we were only looking for the porch hall stairs and landing even though the rest of the house was in a mess.

At this time, they decided to send out a forensic investigator and she would be accompanied by the same BVS inspector that had been proven to be incompetent in the first place and we have subsequently found out lied on his report, suggesting he used pole cameras outside to assess the origin of the metal pole we found, when he most certainly did not.

During the forensic visit we provided some drone images which show that the old pole that was present when we bought the property had been since been removed during renovations unknown to me, and that it could not have originated from the chimney stack after all. My reasonable and logical suspicion of a pole that I was able to prove was on the property before works began from old footage was clearly incorrect. I found out a week or so later after a few anxious nights of no sleep worrying about the implications, that the pole was in fact something my son had used to extend his reach while cleaning gutters out with a trowel, which he had inadvertently left of the large chimney stack while he was cleaning up.

This was explained to the insurers, so the forensics wanted to interview my son, which was facilitated and he explained what had happened.

The forensic report has recently been forwarded by the ombudsman after I lodged a complaint due to the time that has been involved and their treatment of us throughout. I have found a significant amount of inconsistencies, and the report is heavily based on guess work, estimates and opinion rather than facts. With the porch being completely rebuilt and no pole available to inspect, it is hard to understand how the forensic investigation could have been anything other than an opportunity for the insurers to wash their hands of the case based on conjecture, yet the ombudsman has declined to side with us and given much weight to the forensic report considering it was independent, and have rejected the claim.

The costs of these works has been in excess of £30K which was all agreed as the quotes went through, and emails can confirm this. What I would like to know is if the RSA loss adjuster by agreeing these costs and knowing we had begun works has accepted the claim on behalf of the insurers. They are claiming that because I didn't accept the original offer of just over £20K, on the 5th December, even though the loss adjuster accepted in reply emails he had calculated the figure incorrectly, and omitted some of the previously agreed costs, they are not obliged to pay anything. They were entitled to investigate further and a flimsy forensic report with steering by BVS to clear his name was the reason. The title of the report from forensics is "Damage caused by Rot" for instance, which stinks of BVS influence, considering that is not what we were claiming for, and she has not once referred to the RSA loss Adjuster nor has he been involved since the 5th December as he was "sick" and now no longer works for the company.

Any guidance would be most appreciated. We are in financial difficulties after heavily loading credit cards, borrowing from family and from our business which is struggling to pay suppliers now, on the strength of this agreed fund coming to pay them all back, and the lack of sleep worrying and what feel like panic attacks, knots in the stomach and sweating are wearing me down. Perhaps RSA policy is to break my spirt but hope I can get a shred of help to fight this one last time. 11 months almost....and counting.

Many thanks if you have got this far reading and in anticipation of you helping with advice.

We don't have all of the information, including what information you provided to RSA when you took out the policy and we have not seen all of the reports produced related to the claim, so it is very difficult to comment.

In this situation, you might want to obtain your own independent loss assessors report, but that would be at your own cost and there is no guarantee it would be helpful. And it might be a bit late in the day, as months have passed since you made the claim.

Were you living in the house, when the claim event happened or was it unoccupied ?

If unoccupied, how long had it been unoccupied ?

Thanks Unclebulgaria. We had completed the restoration within 6 months of buying the property, and we were most certainly living in the property. It had been featured in a self build magazine and should perhaps have been a Kevin McCloud property. We had gone to Iceland for a few days to return to storm Gertrude I think it was referred to.

The policy was for buildings and contents and was to the best of my memory a "plus" policy meaning we were covered for all accidental damage as well as the usual perils.

As I have said, both BVS eventually and the RSA senior investigator had accepted the claim as a valid claim. BVS costs were suspect considering they were for the wrong materials completely but RSA loss assessor was more than happy with the costs and the fact we had started works. The stumbling block was when we asked him to consider the front facade of the house be rendered to match the new porch which he agreed costs for when the damp ingress through the damaged roof was considered worse that initially thought.

What I was hoping was some guidance as to whether it is worth fighting on, and if, based on email documentation suggesting payments were coming for the works already begun are they allowed to renege on the decision of their own investigator.

Normally Insurers accept reports from people who have seen a house up close, as it would be odd for someone sat in an office miles away to come to a different conclusion.

If it were me in this situation, i would write down a brief summary of what the sticking points were with the claim and i would email the CEO of the Insurers, asking them to intervene. Don't make it complicated by going through all of the information. Just say to them the claim was accepted as valid, but now there are the following problems with the claim and it is being delayed in an unacceptable way.

If you can your claim in front of thr executive office of RSA, you might get a resolution.

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Many thanks again for your help. It is worth a try as I am not sure what else we can do. We have been relying on this payment coming through to get our heads above water again, and the feeling of despair is overwhelming. I feel we are loosing grip of everything we have built up because our business is in the doldrums at present. Selling high end British manufactured wood burning stoves in a time of cheap oil and gas and two mild winters isn't doing us any favours. ;-)

I'll try the CEO route and see what happens. If you have any other suggestions or if anyone else has, I would appreciate guidance.

Best regards

Many thanks again for your help. It is worth a try as I am not sure what else we can do. We have been relying on this payment coming through to get our heads above water again, and the feeling of despair is overwhelming. I feel we are loosing grip of everything we have built up because our business is in the doldrums at present. Selling high end British manufactured wood burning stoves in a time of cheap oil and gas and two mild winters isn't doing us any favours. ;-)

 

I'll try the CEO route and see what happens. If you have any other suggestions or if anyone else has, I would appreciate guidance.

 

Best regards

Just try to make it friendly, personal and provide a clear explanation of the current position. I have dealt with a large volume of complaints and it really helps if people are clear what the problem is, plus what resolution they are seeking, within what time frame.

Don't write out a long complaint email like your first post to this site, as that length of email/letter will strike fear into anyone reading it. And the longer the email/letter, the more confusing it can become, meaning less chance of a quick response with a resolution.

Considering what you have just said, I would imagine I have struck fear into everyone then, but the report the forensic investigator produced was in excess of 140 pages, so I suspected that was what they expected, especially while trying to clarify things with the ombudsman case worker. Perhaps adopting your approach to the CEO and maybe the ombudsman themselves might be more productive, but it is hard not to meander when you feel you have so much to say to prove your point.

Thanks again for your efforts. You are a credit to this site, and to be truthful, it was your posts and the volume of them that was the reason I signed up.

Best regards

Considering what you have just said, I would imagine I have struck fear into everyone then, but the report the forensic investigator produced was in excess of 140 pages, so I suspected that was what they expected, especially while trying to clarify things with the ombudsman case worker. Perhaps adopting your approach to the CEO and maybe the ombudsman themselves might be more productive, but it is hard not to meander when you feel you have so much to say to prove your point.

 

Thanks again for your efforts. You are a credit to this site, and to be truthful, it was your posts and the volume of them that was the reason I signed up.

 

Best regards

Thanks.

I think most people become so involved in their situations, that they forget that the person receiving their complaint is not going to able to spend very long reading anything. If you can help them make their job easier, you might get the result you were looking for.

Not sure if the CEO route will work, the process for high level complaints tends to be CEO (head office complaint) then Ombudsman, on the basis when a complaint has gone through the FOS stage it's at the end of the process and the insurer doesn't have to answer to anybody else (bar the courts but that's not a complaint). Try it though, it can't harm, it's worked for others.

To answer the question about authorisation for the work, if the adjuster had appointed someone to carry out the work, or had placed you in a position where you have been prejudiced i.e. carried out work you would not have done otherwise, then they have a case to answer.

I'm not sure on what basis the claim has been rejected, it's not clear form the post, are we talking a "rot of any kind" or is the pole not being considered as storm ?

The OP may have gone to the FOS without any final decision by the Insurers, because they were frustrated by what was happening with the claim.

If so, the CEO or whoever senior gets to look at the complaint, can have a look at the claims file and decide whether they can intervene.

Personally, i am not sure the FOS was the best route to take with anything complicated including a 140 page assessors report. They won't read it or anything that takes time to read. They are more likely to be guided by the Insurers in such cases.

People should ensure that they always present their complaint to the CEO of an Insurers in a clear way, before they think about next stage, if the Insurers continued to disagree with the policyholders. And as soon as you run into difficulty with a claim or any other complaint issue, get the Insurers to fully explain their decision in writing. Then seek advice if you are not sure. Don't let matters drag on, as it will make it harder to gain a resolution.