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Hi , I am new to the forum and really confused on how the insurance claim process work.

 

We were out 1 day in late dec and when we came back we found the house broken in and completely cleared out of most moveable valuables. I informed the police immediately and they came to asses the situation. This was followed by a forensic person but no prints could be gathered.

 

The police was able to identify the back door as the entry point due to scratches on the door near the lever . The burglars seems to have used 1 / 2 pointed devices to move the door from the hinges and free it up.

 

I called my insurance company on the next working day and they acted swift in getting a loss adjustor. The person who visited us very professional and patient with us .

 

We shared with him a list of items which we think had been taken away . To summaries we had electronics worth 3000 & ,Cash and jewelry @ 50000 taken away from home.

 

I have provided most of the receipts for electronic items and in process to collect documents for the jewelery.

 

Content Insurance in current policy is for 40000 £ and high valuables at 15000 £ ..

 

Current -

 

1. I got a call from the insurer underwriter who asked me why did I under insure the house if I had such high ammount jewellry at home. My response to her was we had just moved home and were in process of looking for a safe box or a secure access storage. She asked for my job and annual salary and said if we under insured ourselves it can be considered fraund and the whole claim can be declined. What does this mean ?

 

2. The loss adjustor has now sent me a spreadhseet showing costs of stuff in the house from flooring to clothes to electronics.. what does this mean ?

 

I am really worried about what is happening . Any help here.

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U need now to get your own independant loss adjuster to not accept any offer especially if it is full and fiinal the loss adjuster will try to knock you down to a bare minimum so do not accept any offers the loss adjusters will try to deliberately stall your claim say nothing to them unless it is in writung so get your own L A

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thing is re the alleged under insurance.

doubt that there would be any prosecution for fraud re under insurance! not good of them to say that. at worst they'll only pay out up to the sum insured, subject to the loss adj report. if report is over sum insured, would then be up to them whether to pay out over the sums insured or not, given the report etc

if however, claiming for something that was not stolen/doesn't exist, then that may be an issue re fraud.

Edited by Ford
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We shared with him a list of items which we think had been taken away . To summaries we had electronics worth 3000 & ,Cash and jewelry @ 50000 taken away from home.

 

I have provided most of the receipts for electronic items and in process to collect documents for the jewelery.

 

Content Insurance in current policy is for 40000 £ and high valuables at 15000 £ ..

 

Current -

 

1. I got a call from the insurer underwriter who asked me why did I under insure the house if I had such high ammount jewellry at home. My response to her was we had just moved home and were in process of looking for a safe box or a secure access storage. She asked for my job and annual salary and said if we under insured ourselves it can be considered fraund and the whole claim can be declined. What does this mean ?

Hello there.

 

I hope you'll have other comments, but I think you might need to do a bit of homework on whether the under-insurance happened. Your sum assured was £55,000 and you lost £53,000 if I've understood what you said above.

 

My understanding from the insurance exams 100 years ago is that you're meant to insure everything in the house, which doesn't leave you much leeway if you're saying everything else is only worth £2,000. That could be what they're talking about, or have I misunderstood something?

 

And also, many policies have a maximum amount they will pay per item if it's lost, the same for cash so I would check that too.

 

Did you have any other cover for individual items with high values like expensive rings for example?

 

I hope I'm wrong to be pessimistic, but I think it would help if you understand the exact terms of your cover.

 

My best, HB

Illegitimi non carborundum

 

 

 

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honeybee

afaik, there would need to be a total sum insured (40 in this case from what dave says) and any specific high values (over a certain amount) would need to be mentioned and included within that total? so, sum insured would not be 55k.

Edited by Ford
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Sorry for the confusion and not reading what I was exactly typing .

 

The policy has a content insurance of 40 K out of which 15 K is on high value items ( no sinle item more that 2500 ) . So its all part of 40 K.

 

I think what the adjustor is trying to do is now sending me a spreadsheet of possible value of contents at home , which he has derived at 35 K and will then end up saying you are only due 5 K as that is what if left .

 

Sorry if I am going off topic.

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are you saying that they are only offering 5k? ie they have valued what is there now after the burglary @35k? and cf the sum insured?

then, would need to challenge, and as suggested perhaps get an alternative opinion.

as said, problem is re the sum insured. will they go over it?

Edited by Ford
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Sorry for the confusion and not reading what I was exactly typing .

 

The policy has a content insurance of 40 K out of which 15 K is on high value items ( no sinle item more that 2500 ) . So its all part of 40 K.

 

I think what the adjustor is trying to do is now sending me a spreadsheet of possible value of contents at home , which he has derived at 35 K and will then end up saying you are only due 5 K as that is what if left .

 

Sorry if I am going off topic.

 

I don't think you're off topic. Would you mind confirming what your actual loss was please?

 

HB

Illegitimi non carborundum

 

 

 

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When there is apparent under insurance at the time of a material damage claim, the "condition of average" is usually applied. What I believe the Loss adjuster is trying to do is to establish the total value at risk at the time of the loss.

 

The condition of average means that any claim will be reduced in proportion to the amount of under insurance. For example, if the total value at risk at the time of the loss was £80,000 and you were only insured for £40,000 (i.e. 50% of the value at risk), the payment will be reduced by 50%

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i see. in this case, as said, seems adjuster is working to the sum insured cf. what is there post the burglary. ie what is the value of contents after the burglary (35k) cf to the sum insured (40k) ie 5k being the difference. as said, depends whether insurer is willing to go above the sum insured, and if so, by how much.

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Here's a link to an article in the Telegraph that sheds some light on underinsurance/average clauses. I agree with Northerpug that this could be where the loss adjuster is heading.

 

http://www.telegraph.co.uk/finance/personalfinance/insurance/buildingsandcontent/8260054/6.8-million-homes-are-underinsured.html

 

HB

Illegitimi non carborundum

 

 

 

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Thanks all.

 

The value of the loss is around 60 K .. I know its more than what the content value was.

 

But seeing the adjusters assessment of what is left which is 35 K .. and he is counting things like carpeting , toiletries.. ... I guess I will need my own loss adjustor to manage him and the insurance company .

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yes, but as said seems adjuster is not working to that!

either way, and, as said, q still remains whether insurer will go over the sum insured, or their equation, given the apparent under insurance.

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Thanks .. so If I go with that logic .. correct me if I am wrong

 

Content insurance in policy - 40 K

House Loss - 60 K

Total Content or value at home - 100K

Insurance is only 40 % of the total value at home - so will they be looking at paying out only 40 % of 60 K .

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work on the sum insured 40k only cf the real value following the adjusters report.

adjuster says current value following burglary is 35k. your sum insured is 40k. you say loss is 50k. and they are offering 5k?

Edited by Ford
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Thanks .. so If I go with that logic .. correct me if I am wrong

 

Content insurance in policy - 40 K

House Loss - 60 K

Total Content or value at home - 100K

Insurance is only 40 % of the total value at home - so will they be looking at paying out only 40 % of 60 K .

 

I'm sorry, I'm probably being thick. What was the value of your contents at the time of the burglary please?

 

HB

Illegitimi non carborundum

 

 

 

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no, work on the sum insured 40k only cf the real value following the adjusters report.

adjuster says current value following burglary is 35k. your sum insured is 40k. you say loss is 55k. they are offering 5k?

 

What does CF mean ?

 

This is the note from adjustor

 

I also attach an appropriate value at risk form that I have collated on the basis of my initial

observations at the time of my visit and would appreciate your input to confirm the figures are

correct or if any ammendments need to be made. I would ask you to sign and return the form

accordingly as this needs to be submitted to Insurers for their consideration.

 

So will I get only 5 K back ..

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What does CF mean ?

 

This is the note from adjustor

 

I also attach an appropriate value at risk form that I have collated on the basis of my initial

observations at the time of my visit and would appreciate your input to confirm the figures are

correct or if any ammendments need to be made. I would ask you to sign and return the form

accordingly as this needs to be submitted to Insurers for their consideration.

 

So will I get only 5 K back ..

 

I'm not sure the 5k is right, but we seem to be getting a bit bogged down in figures.

 

You lost £60k of contents. Are you saying the total value of the contents was £100k or have I misunderstood please?

 

HB

Illegitimi non carborundum

 

 

 

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aah ok..Thanks ..

 

Any references of a good loss adjustor which I can involve ? or a link for professional directory ..

 

There must be a professional organisation for loss adjusters, I would think. It's against site rules to recommend firms, I'm afraid.

 

HB

Illegitimi non carborundum

 

 

 

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yes that right . We lost Items worth 60 K but the policy was only for 40 K .

 

and now the claim adjustor has sent me a value of good at home ( not stolen ) at 35 K.

 

Sorry..I could be confusing everyone.

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