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Water damage claim with AXA, they are being awkward!


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I have a home insurance policy with AXA. Last year, I had a pipe break that is set into the screed, causing lots of damage to the kitchen. This is covered by the AXA policy.

 

I called them up, and three weeks later a surveyor from Imperial Consultants came out. He spent about 30 minutes at my house, and that afternoon he called to say he thought a figure of just over £3k was sufficient to repair the damage. I thought this was pretty unrealistic and told him so on the call; just the original floor in the kitchen had been £3k materials, and the units were £30k, painting £3k. He had included for repainting all the units in his £3k estimate.

 

I have had two contractors in to look at the damage, and they've both given verbal figures in the £20-40k region; so significantly different it wasn't worth getting an accurate quotation from them.

 

AXA then agreed to send out "Crawford Repairnet" who subcontracted a local builder to look at the work. He produced a schedule of works which is vastly different to the first surveyor, e.g. considerably more, and AXA have sent this through to me. Because of the size of the quote from this builder, they have arranged for a loss adjustor from Crawford to come and assess things next week.

 

In the mean time, I've paid for my own surveyor who has assessed the damage and produced a report for me. I've offered this to AXA but it has not been taken up. He spent about 2 hours at my property, compared to a quarter of that for AXA's own surveyor.

 

Furthermore, AXA are being very strange in their attitude towards me. They're refusing to produce information I request, for example the costs that their builder has quoted them, and the costs their surveyor originally assessed. They gave me a redacted version of both reports, with the costs removed, citing they would not disclose costs as they were commercially sensitive.

 

I have already written to them requesting information (that they supplied in redcated form), with a Letter Before Action citing the Civil Procedure Rules.

 

My fear is that their loss adjustor will come and argue things left, right, and centre, and I will be without my kitchen in an acceptable state for months. It has already been 10 weeks, and their actions have caused considerable delays.

 

Additionally, the schedule of work is such that the kitchen is going to be out of use. My wife is at home during the day, and we have a toddler and newborn, so really cannot cope without a kitchen. Maybe if it was just the two of us potnoodles would work! We are insured for alternative accomodation though, although it would be a real pain the back side as anyone with young kids will know.

 

So, my current thinking is as follows:

1) Do Subject Access Requests on the builder, Crawford Repairnet and Imperial to disclose all the information AXA are not prepared to disclose.

2) Get a builder to quote for the work my surveyor has suggested.

3) Issue a county court claim for my builder's quote.

 

Hopefully this course of action will spur AXA to reach a satisfactory settlement without going to trial. However, if it does not, at least it has started the clock ticking for them.

 

Could I have feedback; is this a sensible course of action, is there anything that I've missed?

 

Are AXA allowed to refuse to disclose information to me under the Data Protection Act because it is 'commercially sensitive'?

 

Many thanks all!

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Do not start too much of war with your insurer yet, I can assure you they will put a up a good fight and it will not get the work done any quicker, indeed it could be even slower.

 

As they have instructed a loss adjuster this should help if they are independent - like Crawfords are.

 

A good loss adjuster will provide you with a fair outcome.

 

Loss adjusters usually get paid a percentage of the claim so it is not in their interest to reduce the claim unnecessarily. However, this will be tempered with the fact that AXA are likely to put a lot of work their way.

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Agree with Guido.

 

See what happens next week. Don't pick a fight yet

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Hi edb49,

 

AXA may be unwilling to provide you with the costings due to the fact they will get a discounted price using their own preferred supplier. This costings forms their "limit of liability".

 

However, should you request a cash settlement, I would expect them to reveal this cost - please be warned it may be significantly less than your own contractor - use the Scope of Works (Schedule of Works) to compare what repairs have been proposed.

 

Kind regards,

 

Andy

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I have had experience of Crawfords with my claim and they are not independant they are working for the insurance company.My own experience of them is they are completely biased towards the insurance company - think about it they are paid by the insurance company to minimise the cost of the claim.

 

As your claim is sizeable the only course of action for you is to instruct a loss assessor to work for you and on your behalf.They usually charge about 10% of the claim but believe me they will more than save you this with the additional amount they will get you and to which you are entitled.

 

I have had experience of this and believe me the difference between the insurance companies assessor and your own assessor is usually vast.The insurance company also does not inform you of all of the things you are entitled to claim for relying on people not understanding the full claims procedure.

 

Good luck with your claim remember you have paid your premium to be covered and all you are asking for is them to honour the contract !

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AXA may be unwilling to provide you with the costings due to the fact they will get a discounted price using their own preferred supplier. This costings forms their "limit of liability".

 

Unwilling, yes, I can understand. But are they not required to disclose this information under the Data Protection Act part 7, and the Civil Procedure Rules, Pre-action conduct Annex A, 2.2(4)? (I have made a formal request under the latter but not the former yet.)

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Do not start too much of war with your insurer yet, I can assure you they will put a up a good fight and it will not get the work done any quicker, indeed it could be even slower. As they have instructed a loss adjuster this should help if they are independent - like Crawfords are. A good loss adjuster will provide you with a fair outcome. Loss adjusters usually get paid a percentage of the claim so it is not in their interest to reduce the claim unnecessarily. However, this will be tempered with the fact that AXA are likely to put a lot of work their way.

 

I have had experience of Crawfords with my claim and they are not independant they are working for the insurance company.My own experience of them is they are completely biased towards the insurance company - think about it they are paid by the insurance company to minimise the cost of the claim. I have had experience of this and believe me the difference between the insurance companies assessor and your own assessor is usually vast.The insurance company also does not inform you of all of the things you are entitled to claim for relying on people not understanding the full claims procedure.

 

Firstly, thanks everyone for their replies! I've quoted the two replies as they neatly summarise where I've got to with my thinking. It's good that they've got their loss adjuster instructed, but based on experience so far with their "independent" experts, I'm not expecting the loss adjuster to handle the claim fairly.

 

Assuming the adjuster doesn't come back with the same schedule of works my independent surveyor (who incidentally inspected the kitchen 18 months ago as part of a full home buying survey), then it will be a negotiation with AXA. Everything they have done so far has taken lots of time and served to frustrate a quick settlement, so I would assume that any further negotiation will add considerable time to the matter.

 

What I'm trying to achieve is to get my kitchen back to the state it was pre-incident, as quickly as possible. It seems AXA is offering "quick, but not fully restored" or "fully restored, but not quick". I don't see what option I have to put pressure on AXA to speed things up, apart from court action. I've already put in a complaint to the FSA about the timescales AXA have taken to handle the claim.

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As soon as you have your own loss adjuster working for you the attitude of the insurance company will change and they will want to get your work started as soon as possible.

 

They dont like people to know that they are entitled to appoint their own proffessional as it means they would have to pay out the claim in full including all the things you are entitled to but they never tell you about.

 

Believe me appoint your own loss adjuster and watch how fast they react !.

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As soon as you have your own loss adjuster working for you the attitude of the insurance company will change and they will want to get your work started as soon as possible.

 

Believe me appoint your own loss adjuster and watch how fast they react !.

 

I've already appointed my own surveyor - I'm not quite sure what a loss adjuster would do that my surveyor hasn't already done? The only outcome I can see of me appointing a loss adjuster is they produce a figure which is different to that the insurance company produces, and we then have an argument about it. This is pretty much the same situation as we are in at the moment, where the argument is going to be about my surveyor's schedule of works versus the insurance co's own. Have I missed something about what a loss adjuster does?

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The difference with a loss adjuster and a surveyor is not comparable they are completely different.All your surveyor does is look at the work that needs doing and provides a cost through a building contractor to carry out that work.

 

It appears from your post that you have paid for a surveyors report and the insurance company have more or less ignored it.You have waited 10 weeks and are no further forward - this is standard policy the insurance company knows the longer they mess you about the - more desperate you become - the less you will accept.

 

A loss adjuster works on your behalf and manages your claim.They deal directly with the insurance company and will claim everything you are entitled to and make sure that your claim is processed in a proffessional manner.The cost of their fees is usually more than covered by the additional amount they will claim for you.Had you employed one at the start of your claim I believe you would be a lot further forward as the longer your claim goes on the more it costs the insurance company.

 

At the moment they have a loss adjuster and you dont.Whatever they tell you about them being impartial dont believe , they are working for the insurance company,they get paid a percentage of what they save on the claim. At the moment your at a gunfight and you dont have a gun - get yourself a gun get your own loss adjuster.Good luck with your claim.

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A loss adjuster works on your behalf and manages your claim.They deal directly with the insurance company and will claim everything you are entitled to and make sure that your claim is processed in a proffessional manner.The cost of their fees is usually more than covered by the additional amount they will claim for you.Had you employed one at the start of your claim I believe you would be a lot further forward as the longer your claim goes on the more it costs the insurance company.

 

Thanks for the advice, I'm going to give the insurance company a timescale on which I'll appoint my own loss adjuster then. However, one thing you mentioned I don't quite understand - why does it cost the insurance company more when the claim goes on longer?

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Hi, Im not sure where he is coming from....

Firstly, its called a Loss Assessor - Loss Adjusters will work for Insurance Companies only. If you appoint someone to help you is a Loss Assessor.

 

Personally, when I worked in Buildings / Contents Claims I did not hold them in good regard. They were always asking for cash settlements, on an indemnity basis, rather than replace through our preferred suppliers, so they go the cash back.... They also were not that knowledgable... Before everyone jumps on my back, as I said, my personal opinion.

 

The problem you have at the moment is that the units were not "standard" units. All Claims Adjusters will have what they call a delegated authority. In my experience it was up to £10k, before they had to refer to a supervisor.

 

The fact that your units alone came to £30k means that this claim is getting referred up the claims pyramid, which unfortunately takes time.

 

I would agree with the majority of the posts on this. By all means keep in contact with your Insurers on a regular basis, but don't start the war yet. Once you have a definitive value from the insurers, and it is not what you were wanting then go for it.

 

PS, DEFINATELY GET THE ESTIMATE FROM YOUR OWN BUILDER IN THE MEANTIME!!!

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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loss assessor/loss adjuster same thing only one is working for you and one is working for the insurance company.The reasons the longer the claim goes on the more it costs them are numerous and varied but i will give you one small example that probably fits your claim .You say that your kitchen floor and kitchen both have extensive damage and it sounds like they are out of use now but will definately be during refurbishment.

 

Also your washing machine would also probably be in the kitchen and be out of use also.The insurance company should be reinbursing you for meals and also for the cost of taking your clothing to the laundrette they wont tell you that you are entitled to this but your loss assessor will claim this back for you when he is managing your claim.Also he deals with the insurance company direct so no more getting the runaround off them on the phone.

 

It has taken the insurance company loss adjuster 10 weeks to refer you up the claims pyramid.Your kitchen is a 30k kitchen with a 3k floor you told them this at the beggining both your builders knew this but the insurance company surveyor valued the damage at 3k a huge difference.

 

Loss adjusters look at claims 8 hrs a day 5 days a week - the difference between a 30k kitchen and a 3k kitchen is vast im a builder i have seen hundreds of kitchens and in 5 minutes you have an idea of the value as both your builders confirmed ,why has it taken the loss adjuster 10 weeks to realise this.As I said in my earlier posts its a delaying tactic I see it all the time he should have escelated your claim immediatly as it was obvious the work was over 10k.

 

With regards to the preffered suppliers these are often preferred by the insurer only - read the other posts and make your own mind up preferred usually means cheaper.I have taken over several contracts for clients when they are unhappy with the quality of the work or by the delays in starting or finishing the work by the insurance companies preffered supplier.

 

Its true insurance companies dont like you having your own assessor.One of my customers recently had a large claim and insurance company offered him 30k + to settle he employed his own assessor and the final claim came to over 100k it doesnt take a lot to work out why they dont want you to have one.

 

Whatever you decide to do good luck with your claim.

Edited by bernie129
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I'm in a similar boat. I had an "Escape of water" incident in the bathroom and lodged the claim early December. Crawford & Co. were appointed as the loss adjusters and arrived 1 week later. They left telling me that a drying company would be appointed within the week.

 

Didn't hear anything so eventually complained to Axa about lack of correspondence from Crawford in January. On numerous occasions, I asked for a specification of works for the job in hand all of which were ignored.

 

Crawford & Co. eventually appointed a builder who lives 1.5 hours commute from me. I checked him out and he wasn't a member of any of the schemes he claimed on his website so I said that I wouldn't accept him. Repairnet seemed completely unperturbed that what he was doing is illegal. They forgot to tell him this, so he actually visited my house. Crawford then told me that he was the only builder that they had to cover my postcode so my only option was to appoint my own builder.

 

As Crawford continued to ignore my requests for the specification of work and bill of materials, I then produced my own and sent it to them for review. They verbally told me to go ahead and get quotes. Once I received 2 of the 3 quotes, I sent them back to them with a detailed site questionnaire filled in by the builders.

 

I expected at this point, Crawford to start negotiating on cost of materials. Their opening gambit was that they would only accept the lower of the 3 quotes as the starting point. They then went on to query the specification of works and bill of materials, saying that the loss adjuster's specification of works didn't cover a new bath or toilet. I then demanded to see the loss adjuster's specification of work and as per yourself, I received it yesterday minus the rates and missing quite a bit of work that all 3 of my builders say needs to be done.

 

From reading this email trail, it sounds like it will be in my interest to engage a loss assessor. I'm waiting for the 3rd quote now and have just posted my job to some more builders so that I can get a better average. As there's almost £3k difference between the 1st quote and the 2nd quote, I imagine that a loss assessor may well get me the average of these 2, rather than the lower minus any adjustements to costs of materials which is obviously what Crawford's are aiming for. In terms of accomodation, I've already made it clear that if I need it, I'll give them 24 hours notice and if they fail to arrange accomodation in that time then I'll go ahead and arrange it myself. This is because getting hold of the claims handler is extremely difficult. He even had an "out of office" email up at one point claiming that he was on holiday for 3 weeks, and admitted that he'd put it up to delay other complainants. I've also made it clear that the drying company is also outside of any negotiated claim and that the cash settlement will only cover what's in the final spec of works and bill of materials.

 

I wouldn't have thought that Axa/Crawford & Co. would have a duty to reveal the loss adjuster's quote, however (correct me if I'm wrong on this), but they have a duty to restore my bathroom and your kitchen to the state that it was in prior to the incident, so any cash settlement that you do agree must cover these costs. Just be careful that you're 100% sure that it will before signing anything.

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I wouldn't have thought that Axa/Crawford & Co. would have a duty to reveal the loss adjuster's quote, however (correct me if I'm wrong on this), but they have a duty to restore my bathroom and your kitchen to the state that it was in prior to the incident, so any cash settlement that you do agree must cover these costs. Just be careful that you're 100% sure that it will before signing anything.

 

Well, I've sent a Data Protection Act SAR (Subject Access Request) to Crawford, AXA, their builder and their surveyor, so it will be interesting to see what information they come back. I think they do have a duty to disclose the quotations under this, but I am not 100% sure.

 

Regarding any settlement, I will only make it on the basis that it is not final, and I can come back for more if during the course of the works it is found further damage has occurred, or else there is further damage that isn't apparent now that becomes apparent in the future.

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edb49 good idea to do your subject access request and as this can take up to 40 days this should come through while your work is progressing.This will give you a lot more information as to exactly what is happening with your claim and will come in usefull if you have further problems.

 

Its interesting to read all the posts regarding peoples treatment by the loss adjusters and still find that some people actually believe them to be impartial and working with equal interest for both parties.I havnt read many posts on here praising them up and saying how marvelous they are.

 

It doesnt matter how competetive your insurance company policy is or what they promise you when you take it out the only test of how good they are is when you make a claim.Remember they are not doing you any favours paying you out on a claim, its a two way contract you pay your premium and they give you the insurance cover you have paid for otherwise they are in breach of contract.

 

Keep us informed as to how your claim progresses and good luck.

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I don't think any insurer claims the adjuster is impartial, it's just not possible, they are appointed by the underwriter to negotiate the settlement fairly, but always to save costs for the underwriter, otherwise claims would run amock and premiums will reflect this. In the same way as an assessor will try to claim the most for their customer, because they want the most for themselves. Some assessors are also adjusters, they tend to be better as they work for both sides and have a better view.

Jdey123, the insurer will argue if you didn't want the cheaper builder to do the job, why provide it? why not get another?the insurer is always going to go for the cheaper option. You have presented a claim which can be settled for X, but now want more, all you can do is try to negotiate. You don't need a loss assesor taking 10-15% of your claim cost, your doing it right.

Point to note, they are lumped in with the claims farmers, accident management companies and solcitors. Insurer defenses go up and sometimes they will pay more to get one over than pay a settlement to the customer.

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"Jdey123, the insurer will argue if you didn't want the cheaper builder to do the job, why provide it? why not get another?the insurer is always going to go for the cheaper option.".

 

Why get 3 quotes, if only 1 will be accepted. Rationally, the median of a reasonable range of quotes is the fair and reasonable offer. The cheaper quote means that the policyholder can only get the work done without being out of pocket, if the builder is willing to proceed at the original price. Besides, the lower of the 3 quotes is the insurer's opening position not his final one, so asking me to settle for less than the lower of the 3 quotes would not meet the requirement that they have to restore my bathroom to it's original state or provide a cash settlement which enables me to do this. Any negotiations down would have to be accepted by the builder.

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On the subject of the 3 estimates for the work I am a builder and let me tell you how it works.Most people will find it difficult to get 3 estimates for bigger jobs as builders know from past experience that the chances of getting the work are next to nil.

 

Insurers like to use their own preffered ie cheaper building contractors,the customer usually only gets the builder of their choice when things start to go wrong or the delay in starting goes on forever.

 

To work out an estimated cost for repairs for say a 20k to 30K job can take you a full day or more of sourcing materials,working labour costs out etc.Also insurance companies are notorious for being slow payers.its no wonder builders do not want to provide a free estimate for work that they have very little chance of getting.

 

Most of the people I price insurance work for ( only existing customers) are very happy to get three estimates as they have usually rang dozens of builders to get them.Another little ruse they like to do is use their preffered supplier but make the cheques out to the insured who then pays the builder.This means that if the work later turns out to be sub-standard the customer and not the insurance company is deemed to have employed the builder and the insurance company will wash their hands of any subsequent problems.

 

I do agree with the point that if the loss adjuster negotiated the settlement fairly you dont need an assessor but read the posts I certainly dont feel that they are treating these people fairly with their claims.All my experiences of loss adjusters are first hand as I estimate building work day in day out.

 

With due respect most people making a large claim have no experience of building work or costings and rely totally on the loss adjuster,read the posts and see how fairly you think they are being treated.

Edited by bernie129
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Good observations there, bernie129.

 

Of course needing to bid for work for free and more times than not, not getting the work isn't just a problem which hits the building trade. For bigger jobs, there's a bigger prize at stake and it would be rare for a householder to get more than 3 quotes for the reasons you've outlined, so there's a 1:3 chance of getting the work which aren't too bad odds.

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Ok, got the 3rd quote at last. The quotes are now:-

 

1. £10k

2. £9k

3. £6.5k

 

Obviously, the insurance company have been trying to hammer me down on the lowest of these 3 quotes. Any advice on how to proceed? If a loss assessor will charge me 15% but can get the highest of these 3 quotes then it would obviously be worthwhile me pursuing this option. I'd make sure that I didn't sign anything unless it guaranteed me a settlement minus his fee which was higher than the mean of these 3 quotes - £8.5k.

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You have to be very careful. Assesors may want a percentage of the whole claim, not just the building they are picking up for you. You need to lay down the terms, but there is nothing to suggest they will accept this.

There are too many what if's and but's here to give any reasonable advice. Until you actually speak to a firm you will never know.

good luck.

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jdey123

 

Might not have made it as clear as i should on 3 estimates.What happens is usually you can price dozens of jobs with insurance companies and get none.The preffered insurance company builder is nearly always the cheapest and even if they are not the insurance company usually uses them anyway

due to getting discounted prices.We dont price insurance company work now unless its a favour for an existing customer most builders are of the same frame of mind thats why its usually difficult to get your 3 estimates.

 

Also a lot of the companies that award the building contracts for insurance companies are linked in some way to that company.If it was a case of getting 1 in 3 like estimating for normal jobs we would be happy to do it.

 

We used to do emergency call outs for one insurance company who then contracted the work to a subsiduary who wanted the work doing so cheap we stopped working for them.Basically they wanted you to do 24hr call out - if you got called out at any time you had to be on the job in 1hr if it was within 15 miles - if the job was more than 1 hr you had to call in and authorise it - paperwork had to be supplied in triplicate and was paid 1 month from invoice.

 

Now think about it you go out at 1am in the morning to get paid 1hrs work no travel time within 15 miles - your 1hr starts when you knock on the door of the customer and you get paid in 1 months time after filling in paperwork in triplicate - thats why we stopped doing emergency call outs for this company and thats why you often wait for hours and hours to get an emergency contractor.That was about 6 years ago have they got any better -probably not !.

Edited by bernie129
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