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I have a claim with a Insurance company for a damaged sofa (value 2900) the Insurance is with a subsiduary of Liverpool victoria, the claim has been refused as they state that their assesors have looked at the report, which has stated it is wear and tear and that there is no one off incident, there is wear and tear on the head area as it is analine leather but the seats are clearly damaged due to food spillage on the seating.

 

They have refused the claim stating that the assesors have looked at the report, and despite the report indicating that the damage is beyond economic repair, they can not confirm if the damage was due to a one off incident but that they question liability as it appears to be like wear and tear, the muppets from Davies group have again rejected the claim, when I complained after getting the SAR, which is showing that the pictures are not clear and they have chosen to use wear and tear as the exuse, They have issued a final response, despite me highlighting the inconsistencies in the report and the photographs, by incating the claim is denied based on the report and the comment that the "damage appears to be consistent with wear and tear" they have given details of the Ombudsman but I am not sure if it is a idea to issue a small courts claim in stead or what the best way is to deal with this matter, all advice appreciated

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any advice appreciated as I have just about had enough of these idiots, they have rejected the claim again and again saying its wear and tear - when there is another sofa in the same room with no damage to it.

 

Any help appreciated

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Initially go through the FSA. The Insurance Company are bound by their decision, but you are not. However, the insurers have now basically said it is up to you to prove the loss - Get your own report on the sofa to back your argument up.

 

Regards

 

Craig


Abbey - owed £3260 - Paid up.

 

Barclays owed £2500 - Paid up.

 

Halifax, Mint & Egg - next on the hit list

 

Dont click on the scales - I'm quite proud of my little red dot! - As the little red dot has gone - click away!!!!

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thank you CW I have taken the matter to the FSO, as stated, if they do nothing then will proceed to court, as I have pictures of the other sofa, which should have been the comparison for any wear and tear, especially as this one has no marks on it or wear as they have assumed on the damaged one.

 

Thank you, I will post up as soon as I get a response from the FSO

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What level of cover do you have? New for old or indemnity? If indemnity, then what you tell makes some sense.

 

Secondly, did the adjuster take photos? Do you still have the sofa?

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Hi MicheleFloyd

 

Originally they told me nothing was covered as I had not taken Accidental damage, then I sent them the policy cover document confirming they were wrong, they are the claims handlers for Highway Choice (Part of the LV group).

 

They employed a furniture restoration company called Frontline they confirmed the sofa was beyond economic repair and stated it should be replaced, they then went on to say that the damage on all the sofas was possibly due to wear and tear, they took loads of photos of the 4 seater, which was damaged and then passed these off as the two seater comparison too, hence all had the same wear and tear.

 

I wrote a complaint indicating that they have failed to compare the true wear and tear on the 2 seater as that is not damaged, they ignored this and rejected the claim, indicating that Frontline, could not be clear if the damage was down to a one off incident.

 

The above company took photos and did a report, which Davis refused to give me, so I did a SAR and received all the photographs and details, in some parts of the file it is clear that they agreed the damage was BER but did not agree that it was a one off incident.

 

I have the sofa still, and have today posted the complaint detailed as below to the FOS to investigate - any help appreciated

 

Financial Ombudsman Service

South Quay Plaza

183 Marsh Wall

London

E14 9SR

Complaint against Davies Group – Claim mishandling and refusal

Dear Sir/Madam

Please find attached a complaint form and documents to confirm our complaint against the above Insurance claims handling group.

We have been unable to reach a resolution to this matter since October 2009, the final response was e-mailed to me by them on 7 January 2010, I had intended to take this matter through the small claims Court, but have been advised that the complaint must be addressed through the Ombudsman service.

I understand now that this would achieve the same solutions based on the facts and the proximate damage which is covered by the Insurance policy in force at the time of the accidental damage to the 4 seat sofa.

I can submit photographic evidence of the 2 Seat Sofa to show the comparable which should have been used and has never been requested from me, however you will see from the attached documentation that this should have been, this information was sent to be under the Data Protection Act at the end of January 2010.

Please can the file be requested by the FOS directly from the Insurance Company claims handlers Davies Group as they have all the documents including these attached on file.

I hope that this matter will be investigated and the outcome which should have been based on the above facts and the claim paid is completed as soon as possible. Thank you for your assistance.

Yours Sincerely

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Bump For Advice Pls

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Hi there,

 

Personally I would not go down the route "The 2 seater is not damaged" as the only route - they could quite easily explain that away by the fact that the 2 seater is not used as much as the 3 seater.

 

I would place the emphasis on the fact there was a food spillage on the 3 seater. There may be elements of wear and tear, but you are certain food was spilled on a one off incident, and the fact that Davies cannot be sure there was not a food spillage makes their argument full of holes.

 

With insurance claims you have to prove the loss - the fact there is staining on your sofa proves this. The emphasis now shifts to the Insurer to prove the loss does not fall under cover - they have failed to do this on this occasion.


Abbey - owed £3260 - Paid up.

 

Barclays owed £2500 - Paid up.

 

Halifax, Mint & Egg - next on the hit list

 

Dont click on the scales - I'm quite proud of my little red dot! - As the little red dot has gone - click away!!!!

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Thank you Craigwalton, I will note that as I have sent the complaint in already but have indicated that the damage was purely down to food spillage, however I did compare it to the 2 seater but will push the above point now in further letter to the FOS when they contact me.77

 

Thanks for that pointer

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Hi intree, sorry for the delay. Why do they cite wear and tear? Did they find that the age of the stains did not match, meaning that the sofa had been stained more than once? Did the adjuster find a perfect couch other than that one food spillage incident?

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hi Michele, Their assumption is based on the fact that the cushions on the 4 seat sofa stains which in their opinion are consistent with wear and tear staining/use, however the sofa is 3 years old and is made of analine leather, hence when anything is spilt on them it will stain, so when the food was spilled on them during a party our son had, they tried (in vain) to clean the sofa, which caused the sofa to keep all the stains, even from the water they used, I have explained this to the Insurance company, by also indicating that if they assume it is just wear and tear then, this should also show on the other sofa as well as they are both made from the same stainable analine leather.

 

however, because the inspection report stated "we would not be able to confirm that the damage is due to a one off incident or not" however it is consistent with wear and tear.

 

So this is what the whole claim has been refused on, they will also not accept the opinion of another leather technician, as they have stated their final response has been provided and the claim is denied.

 

How fair is that - they are the claims handling company for Liverpool Victoria, one of the worst companies I have ever come accross in any field of service..

 

Thanks

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Good Morning all

I too have come accross the same problem with Davies. On November 8th 2010 a storm took the felt roof of our shed. We contacted Zurich who used Davies to asses there claim. This was handed down to Eastwell contractors who proceeded to sub con it to MD building services. MD came round took photos of the shed and stated that we should not do anything to it as they would replace it. We did, naively, as we were told.

 

After many phone calls to davies we finally got a decision. The report stated that we were not covered as the damage was due to wear and tear on the shed. The storm that night according to Zurich was 54mph winds. This also took some pf our fencing down.

 

I am now left with a shed that has been exposed to rain and snow since november and is now not usable based on what there representative told me, they are denying that this was ever said and we have ' no proof.'

 

The attitude of Davies and the 'I hear what your saying' is frustrating as the shed is only 4 years old.

 

Can anyone advise on what course of action is available to me as I cannot afford a new shed.

 

Many thanks for your time in reading this

 

Dave

:mad2:

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